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Organization
SHEPPARD SPINE & SPORTS CLINIC
Active
Organization
SHEPPARD SPINE & SPORTS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNY R SHEPPARD D.C. (OWNER)
(858) 350-6290
Entity
Organization
Contact information
Practice address
634 STEVENS AVE, SOLANA BEACH, CA 92075-2422
(858) 350-6290
(858) 350-6775
Mailing address
634 STEVENS AVE, SOLANA BEACH, CA 92075-2422
(858) 350-6290
(858) 350-6775
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
15278
CA
111N00000X
Chiropractor
Primary
16059
CA
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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