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General NPI Number Information
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NPI Number | 1639470230
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Entity Type | Organization
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Legal Business Name | GARRISON CHIROPRACTIC
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Dates
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Enumeration Date | 11/12/2010
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 25200 CRENSHAW BLVD STE. 101
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City | TORRANCE
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State | CA
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Zip | 90505-6130
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Country | US
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Telephone | 424-212-9428
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Fax | 424-210-3512
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Provider Business Mailing Address
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Address Line | 627 S CATALINA AVE
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City | REDONDO BEACH
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State | CA
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Zip | 90277-4102
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Country | US
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Telephone | 424-212-9428
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Fax | 424-210-3512
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK GARRISON
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Credential | D.C.
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Telephone | 424-212-9428
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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 | 26721
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License Number State | CA
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