Organization
BACK IN MOTION CHIROPRACTIC KRISTIN BODENBENDER, D.C., INC.
Active
Other names
Back In Motion, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN M BODENBENDER D.C. (OWNER / PROVIDER)
(714) 434-2585
Entity
Organization
Contact information
Practice address
2850 MESA VERDE DR E, SUITE K, COSTA MESA, CA 92626-4891
(714) 434-2585
(866) 390-2850
Mailing address
2850 MESA VERDE DR E, SUITE K, COSTA MESA, CA 92626-4891
(714) 434-2585
(866) 390-2850
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC24289
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770781213
INDIVIDUAL NPI
CA
01
—
676426
OPTUM
CA
01
—
DC24289
CHIROPRACTIC LICENSE
CA
01
—
ZZZ66768Z
BLUE SHIELD
CA
Enumeration date
05/19/2010
Last updated
12/07/2011
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