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Organization
FONTANA CHIROPRACTIC AND ACUPUNCTURE
Active
Organization
FONTANA CHIROPRACTIC AND ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MARK LA.C (CO-OWNER/ACUPUNCTURIST)
(909) 766-5397
Entity
Organization
Contact information
Practice address
13677 FOOTHILL BLVD, STE P, FONTANA, CA 92335-0505
(909) 766-5397
(909) 697-2274
Mailing address
20687 AMAR RD, STE 2, BOX 240, WALNUT, CA 91789-5044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
33617
CA
171100000X
Acupuncturist
17044
CA
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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