Organization
ACTIVE REST CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLAN LEE KOEPPEN D.C. (OWNER)
(858) 736-4056
Entity
Organization
Contact information
Practice address
7825 FAY AVE, 249, LA JOLLA, CA 92037-4252
(858) 736-4056
Mailing address
7825 FAY AVE, 249, LA JOLLA, CA 92037-4252
(858) 736-4056
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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