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General NPI Number Information
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NPI Number | 1760542898
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Entity Type | Organization
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Legal Business Name | LONG BEACH SPINE & REHABILITATION CHIROPRACTIC HEALTH CENTER
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3434 LOS COYOTES DIAGONAL
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City | LONG BEACH
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State | CA
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Zip | 90808
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Country | US
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Telephone | 562-938-8770
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Fax | 562-938-8762
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Provider Business Mailing Address
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Address Line | 3434 LOS COYOTES DIAGONAL
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City | LONG BEACH
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State | CA
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Zip | 90808
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Country | US
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Telephone | 562-938-8770
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Fax | 562-938-8762
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Authorized Official
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Title or Position | CHIROPRACTOR OWNER
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Name | DR. MARTA LYNN CALLOTTA
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Credential | DC
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Telephone | 562-938-8770
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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 | DC24681
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License Number State | CA
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