Organization
220 FITNESS CONCEPTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTEO BAKER (C.E.O.)
(310) 399-0220
Entity
Organization
Contact information
Practice address
220 MAIN ST STE C, VENICE, CA 90291-5218
(310) 399-0220
Mailing address
171 PIER AVE # 283, SANTA MONICA, CA 90405-5311
(310) 399-0220
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
171100000X
Acupuncturist
—
—
Other
Enumeration date
03/14/2011
Last updated
09/22/2011
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