Provider Demographics
NPI:1043062359
Name:IRON CHIROPRACTIC
Entity type:Organization
Organization Name:IRON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMERJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-791-3177
Mailing Address - Street 1:1236 E LOS ANGELES AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2893
Mailing Address - Country:US
Mailing Address - Phone:805-791-3177
Mailing Address - Fax:
Practice Address - Street 1:1236 E LOS ANGELES AVE STE C
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2893
Practice Address - Country:US
Practice Address - Phone:805-791-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty