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General NPI Number Information
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NPI Number | 1275934754
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Entity Type | Organization
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Legal Business Name | PRECISION CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 18419 NORDHOFF ST
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City | NORTHRIDGE
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State | CA
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Zip | 91325-2204
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Country | US
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Telephone | 818-734-0022
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Fax | 818-734-0236
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Provider Business Mailing Address
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Address Line | 18419 NORDHOFF ST
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City | NORTHRIDGE
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State | CA
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Zip | 91325-2204
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Country | US
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Telephone | 818-734-0022
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Fax | 818-734-0236
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE LUIS VILLARREAL
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Credential | D.C
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Telephone | 818-734-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | DC27557
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License Number State | CA
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