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General NPI Number Information
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NPI Number | 1679992564
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Entity Type | Organization
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Legal Business Name | BRAITHWAITE CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 12501 SEAL BEACH BLVD SUITE 160
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City | SEAL BEACH
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State | CA
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Zip | 90740-2763
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Country | US
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Telephone | 562-596-6000
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Fax | 562-596-6040
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Provider Business Mailing Address
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Address Line | 12501 SEAL BEACH BLVD SUITE 160
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City | SEAL BEACH
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State | CA
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Zip | 90740-2763
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Country | US
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Telephone | 562-596-6000
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Fax | 562-596-6040
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. SEAN MARITN BRAITHWAITE
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Credential | D.C.
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Telephone | 562-596-6000
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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 | 32211
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License Number State | CA
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