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General NPI Number Information
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NPI Number | 1720474570
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Entity Type | Organization
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Legal Business Name | DR. B. AUSTIN'S CHIROPRACTIC GRP, INC.
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 4861 CONVOY ST
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City | SAN DIEGO
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State | CA
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Zip | 92111-1610
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Country | US
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Telephone | 619-299-4847
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Fax | 858-565-8504
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Provider Business Mailing Address
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Address Line | 4861 CONVOY ST
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City | SAN DIEGO
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State | CA
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Zip | 92111-1610
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Country | US
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Telephone | 619-299-4847
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Fax | 858-565-8504
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN CONANT AUSTIN
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Credential | D.C.
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Telephone | 619-299-4847
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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 | DC27717
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License Number State | CA
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