Organization
VAN LUE CHIROPRACTIC, INC
Active
Other names
Funxional Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY PETER JAMES VAN LUE D.C. (CEO)
(818) 357-2095
Entity
Organization
Contact information
Practice address
8363 RESEDA BLVD STE 204, NORTHRIDGE, CA 91324-5907
(818) 357-2095
(818) 357-2501
Mailing address
8363 RESEDA BLVD STE 204, NORTHRIDGE, CA 91324-5907
(818) 357-2095
(818) 357-2501
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC32385
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0323850
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
06/24/2013
Last updated
06/24/2013
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