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General NPI Number Information
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NPI Number | 1528243722
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Entity Type | Organization
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Legal Business Name | HOVANESSIAN CHIROPRACTIC INC.
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 600 W BROADWAY SUITE 235
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City | GLENDALE
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State | CA
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Zip | 91204-1033
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Country | US
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Telephone | 818-552-5025
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Fax | 818-552-5026
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Provider Business Mailing Address
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Address Line | 600 W BROADWAY SUITE 235
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City | GLENDALE
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State | CA
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Zip | 91204-1033
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Country | US
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Telephone | 818-552-5025
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Fax | 818-552-5026
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | RAFI HOVANESSIAN
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Credential | D.C.
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Telephone | 818-552-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 30285
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License Number State | CA
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