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General NPI Number Information
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NPI Number | 1871985432
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Entity Type | Organization
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Legal Business Name | WITHERS CHIROPRACTIC INC
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Dates
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Enumeration Date | 02/19/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 4418 VINELAND AVE STE 218
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91602-2159
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Country | US
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Telephone | 818-275-2243
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Fax |
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Provider Business Mailing Address
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Address Line | 15550 ROCKFIELD BLVD STE B220
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City | IRVINE
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State | CA
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Zip | 92618-6703
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Country | US
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Telephone | 949-598-9999
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Fax | 949-598-9990
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. ROY WITHERS
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Credential | DC
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Telephone | 818-275-2243
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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 | DC25028
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License Number State | CA
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