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General NPI Number Information
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NPI Number | 1760703938
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Entity Type | Organization
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Legal Business Name | SARTIN FAMILY CHIROPRACTIC INC
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 8678 19TH ST SUITE 130
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-4559
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Country | US
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Telephone | 909-289-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 8678 19TH ST SUITE 130
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-4559
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CORY MICHAEL SARTIN
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Credential | D.C
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Telephone | 909-289-7155
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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 | DC-31254
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License Number State | CA
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