A Professional Chiropractic Corp.
Organization Active NPI Chiropractor · Lakewood, CA
NPI 1194948067 · NPPES record last updated Jun 13, 2008
Key facts
- NPI
- 1194948067
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 15417 (CA)
- Legal business name
- A PROFESSIONAL CHIROPRACTIC CORP.
- Practice address
- 5220 Clark Ave.
Suite 445
Lakewood, CA 90712 - Phone
- (562) 866-3340
- Fax
- (562) 804-0499
- NPI assigned
- Apr 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Edwin Frederick Von Borstel III, D.C.
- Title
- Chiropractor
- Phone
- (562) 866-3340
Practitioners 2
-
Larry Lloyd Omo, D.C.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 15417 | CA | Yes |
Addresses
Primary practice location
5220 Clark Ave.
Suite 445
Lakewood, CA 90712
Mailing address
5220 Clark Ave.
Suite 445
Lakewood, CA 90712
Phone (562) 866-3340
Other names
- Advanced Back and Neck Care
Other providers in Lakewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.