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Organization
KENTWOOD CHIROPRACTIC
Active
Organization
KENTWOOD CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE A. LAUTERBACH-DAVIS D.C. (CO-OWNER)
(310) 215-9061
Entity
Organization
Contact information
Practice address
7917 EMERSON AVE, WESTCHESTER, CA 90045-1120
(310) 215-9061
(310) 641-8194
Mailing address
7917 EMERSON AVE, WESTCHESTER, CA 90045-1120
(310) 215-9061
(310) 641-8194
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC14123
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC14123
BLUE SHIELD PIN-DC0141230
CA
Enumeration date
08/26/2013
Last updated
08/26/2013
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