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Organization
RUSUDAN DEDIASHVILI CHIROPRACTIC CORP.
Active
Organization
RUSUDAN DEDIASHVILI CHIROPRACTIC CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSUDAN DEDIASHVILI D.C. (PRESIDENT)
(818) 922-7713
Entity
Organization
Contact information
Practice address
13760 VICTORY BLVD, VAN NUYS, CA 91401-2324
(818) 922-7713
(323) 965-1411
Mailing address
13760 VICTORY BLVD, VAN NUYS, CA 91401-2324
(818) 922-7713
(323) 965-1411
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC0255610
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7723436
—
CA
Enumeration date
04/09/2008
Last updated
05/28/2020
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