Provider Demographics
NPI:1528423753
Name:CALLISTER CHIROPRACTIC & TRAINING, INC
Entity type:Organization
Organization Name:CALLISTER CHIROPRACTIC & TRAINING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:B
Authorized Official - Last Name:CALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-395-9955
Mailing Address - Street 1:220 MONTGOMERY ST
Mailing Address - Street 2:SUITE 1084
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3402
Mailing Address - Country:US
Mailing Address - Phone:415-395-9955
Mailing Address - Fax:415-395-9125
Practice Address - Street 1:220 MONTGOMERY ST
Practice Address - Street 2:SUITE 1084
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3402
Practice Address - Country:US
Practice Address - Phone:415-395-9955
Practice Address - Fax:415-395-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3898261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service