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General NPI Number Information
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NPI Number | 1780061622
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Entity Type | Organization
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Legal Business Name | FOUNDATION CHIROPRACTIC, A RITOLA PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 3811 PORTOLA DR
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City | SANTA CRUZ
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State | CA
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Zip | 95062-5232
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Country | US
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Telephone | 831-316-7494
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 PORTOLA DR
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City | SANTA CRUZ
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State | CA
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Zip | 95062-5232
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Country | US
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Telephone | 831-316-7494
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH RITOLA
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Credential | D.C.
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Telephone | 831-713-3481
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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 |
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License Number State |
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