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General NPI Number Information
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NPI Number | 1982651865
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Entity Type | Organization
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Legal Business Name | MARK ELLIOTT AND DEBRA ELLIOTT CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 1621 S MELROSE DR SUITE F
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City | VISTA
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State | CA
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Zip | 92081-5401
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Country | US
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Telephone | 760-598-9200
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Fax | 760-598-9202
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Provider Business Mailing Address
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Address Line | 1621 S MELROSE DR SUITE F
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City | VISTA
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State | CA
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Zip | 92081-5401
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Country | US
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Telephone | 760-598-9200
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Fax | 760-598-9202
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. DEBRA T ASAKURA
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Credential | DC
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Telephone | 760-598-9200
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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 | DC21223
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License Number State | CA
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