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General NPI Number Information
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NPI Number | 1811128838
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Entity Type | Organization
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Legal Business Name | WESTSIDE CHIROPRACTIC INC
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Dates
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Enumeration Date | 08/07/2009
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 3011 RANCHO VISTA BLVD SUITE A
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City | PALMDALE
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State | CA
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Zip | 93551-4821
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Country | US
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Telephone | 661-274-4357
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Fax | 661-538-2024
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Provider Business Mailing Address
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Address Line | 3011 RANCHO VISTA BLVD SUITE A
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City | PALMDALE
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State | CA
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Zip | 93551-4821
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Country | US
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Telephone | 661-274-4357
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Fax | 661-538-2024
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD FRANCIS HACKETT
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Credential | DC
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Telephone | 661-274-4357
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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 18432
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License Number State | CA
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