Provider Demographics
NPI:1174760359
Name:ARTHUR PROFESSIONAL CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:ARTHUR PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-497-2553
Mailing Address - Street 1:330 PARK AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-2352
Mailing Address - Country:US
Mailing Address - Phone:949-497-2553
Mailing Address - Fax:949-497-5273
Practice Address - Street 1:330 PARK AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2352
Practice Address - Country:US
Practice Address - Phone:949-497-2553
Practice Address - Fax:949-497-5273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty