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General NPI Number Information
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NPI Number | 1851458004
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Entity Type | Organization
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Legal Business Name | REILEY CHIROPRACTIC A PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 27131 ALISO CREEK RD #105
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3363
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Country | US
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Telephone | 949-448-9088
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Fax | 949-448-9096
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Provider Business Mailing Address
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Address Line | 27131 ALISO CREEK RD #105
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3363
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Country | US
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Telephone | 949-448-9088
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Fax | 949-448-9096
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JAMES REILEY
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Credential | DC
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Telephone | 949-448-9088
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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 | 24205
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License Number State | CA
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