Organization
LIDDY HEALTH & FITNESS CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH JEREMY YCMAT D.C. (PRESIDENT)
(310) 659-1959
Entity
Organization
Contact information
Practice address
6310 SAN VICENTE BLVD STE 240, LOS ANGELES, CA 90048-5461
(310) 659-1959
Mailing address
230 S JACKSON ST. #104, GLENDALE, CA 91205
(310) 659-1959
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC 31233
CA
Other
Enumeration date
04/11/2015
Last updated
04/06/2016
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