Organization
BLACKWELDER CHIROPRACTIC, INC.
Active
Other names
Capo Beach Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE SPENCER BLACKWELDER D.C. (PRESIDENT/ OWNER)
(949) 240-2546
Entity
Organization
Contact information
Practice address
24721 LA PLZ, DANA POINT, CA 92629-2509
(949) 240-2546
(949) 240-3804
Mailing address
25762 VIA DEL REY, SAN JUAN CAPISTRANO, CA 92675-4444
(949) 240-0483
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC23746
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
CA
Enumeration date
10/26/2006
Last updated
08/22/2020
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