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General NPI Number Information
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NPI Number | 1689066904
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Entity Type | Organization
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Legal Business Name | BODY MECHANICS WALSH CHIROPRACTIC AND SPORTS THERAPY CORP
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 3151 AIRWAY AVE SUITE K103
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City | COSTA MESA
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State | CA
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Zip | 92626-4607
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Country | US
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Telephone | 714-540-1710
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Fax | 714-540-3191
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Provider Business Mailing Address
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Address Line | 3151 AIRWAY AVE STE K103
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City | COSTA MESA
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State | CA
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Zip | 92626-4613
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Country | US
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Telephone | 714-540-1710
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Fax | 714-540-3191
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM MICHAEL WALSH
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Credential | DC
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Telephone | 714-540-1710
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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 | DC32523
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License Number State | CA
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