Provider Demographics
NPI:1700142692
Name:PRIETO CHIROPRACTIC, INC
Entity type:Organization
Organization Name:PRIETO CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ANOTHONY
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-577-0200
Mailing Address - Street 1:17660 YORBA LINDA BLVD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3927
Mailing Address - Country:US
Mailing Address - Phone:714-577-0200
Mailing Address - Fax:714-577-5730
Practice Address - Street 1:17660 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3927
Practice Address - Country:US
Practice Address - Phone:714-577-0200
Practice Address - Fax:714-577-5730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty