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General NPI Number Information
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NPI Number | 1861099129
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Entity Type | Organization
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Legal Business Name | WALIA CHIROPRACTIC INC
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 2577 SAMARITAN DR STE 840
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City | SAN JOSE
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State | CA
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Zip | 95124-4115
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Country | US
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Telephone | 352-399-5085
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Fax | 866-402-3481
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Provider Business Mailing Address
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Address Line | 2307 HAREWOOD DR
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City | LIVERMORE
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State | CA
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Zip | 94551-1777
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Country | US
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Telephone | 909-728-1508
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Fax | 866-402-3481
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. TINA SHALLONIS
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Credential |
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Telephone | 352-399-5085
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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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