Provider Demographics
NPI:1902236094
Name:NARLOCK CHIROPRACTIC INCORPORATED
Entity Type:Organization
Organization Name:NARLOCK CHIROPRACTIC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:NARLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-753-0758
Mailing Address - Street 1:2235 ENCINITAS BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4356
Mailing Address - Country:US
Mailing Address - Phone:760-753-0758
Mailing Address - Fax:760-632-6895
Practice Address - Street 1:2235 ENCINITAS BLVD STE 111
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4356
Practice Address - Country:US
Practice Address - Phone:760-753-0758
Practice Address - Fax:760-632-6895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0192270OtherBLUE SHIELD
CADC0192270OtherBLUE SHIELD