Jack Martin Bourla D.C.

NPI 1013055755 - Chiropractor - 111N00000X

NPI Details
NPI 1013055755
Gender Male
Enumeration Date 02/02/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
499 SEAPORT CT
SUITE 101
REDWOOD CITY CA, 94063-2783, US
Phone (650) 365-1473
Fax (650) 365-1474
Business Location
499 SEAPORT CT
SUITE 101
REDWOOD CITY CA, 94063-2783, US
Phone (650) 365-1473
Fax (650) 365-1474
Toxanomy
Taxonomy Code 111N00000X
License State California
License Number DC25312
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According to our database, Dr. Jack Martin Bourla D.C. NPI is 1013055755, taxonomy code is 111N00000X and license number is DC25312, license state is located at California. Jack Martin Bourla D.C. physically located at 499 Seaport Ct, Redwood City CA, 94063-2783. NPI Number Jack Martin Bourla D.C. has the Individual type.

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1013055755 NPI number is provided on an as is basis without warranty of any kind. 1013055755 is maintained by the National Plan & Provider Enumeration System. The contents of Jack Martin Bourla D.C. are for informational purposes only.