Basic Information
Provider Information
NPI: 1447436431
EntityType: 2
ReplacementNPI:  
OrganizationName: HEALING TOUCH CHIROPRACTIC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 3985 FIFTH AVE
Address2: SUITE 100
City: SAN DIEGO
State: CA
PostalCode: 921033111
CountryCode: US
TelephoneNumber: 6192994847
FaxNumber: 6192994837
Practice Location
Address1: 3985 FIFTH AVE
Address2: SUITE 100
City: SAN DIEGO
State: CA
PostalCode: 921033111
CountryCode: US
TelephoneNumber: 6192994847
FaxNumber: 6192994837
Other Information
ProviderEnumerationDate: 01/21/2008
LastUpdateDate: 01/21/2008
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: AUSTIN
AuthorizedOfficialFirstName: BRIAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6192994847
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DC
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000XDC27717CAY193400000X SINGLE SPECIALTY GROUPChiropractic ProvidersChiropractor 

No ID Information.


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