NPI | 1073871547 |
---|---|
Doing Business As | HEALTH SOURCE CHIROPRACTIC |
Entity Type | Organization |
Authorized Contact | MATTHEW DAVID COSTANTINO Owner/CEO 310-798-3227 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 21279) |
Enumeration Date | 2012-05-02 |
Last Update Date | 2012-05-02 |