# THERAPY CRYO SALON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Therapy Cryo Salon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528727682
- **Authorized official:** DR. MAYMANAT ASHTIANI DC (CEO)
- **Authorized official phone:** (949) 699-2796

## Contact information

- **Practice address:** 22622 LAMBERT ST STE 308, LAKE FOREST, CA 92630-1669
- **Practice address phone:** (949) 699-2796
- **Practice address fax:** (844) 270-6353
- **Mailing address:** 22622 LAMBERT ST STE 308, LAKE FOREST, CA 92630-1669
- **Mailing address phone:** (949) 699-2796
- **Mailing address fax:** (844) 270-6353

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2021
- **Last updated:** 12/15/2021