Stacey Gillis Chiropractic INC

NPI #1477865087 in Costa Mesa, California

Provider Information

NPI Number: 1477865087
Entity Type: Organization
Organization Name: Stacey Gillis Chiropractic INC
Primary Specialty: Chiropractor
Enumeration Date: Jul 12, 2010
Last Updated: Jul 12, 2010

Practice Location

Address: 2200 HARBOR BLVD
Address 2: SUITE B-160
City: Costa Mesa
State: California
ZIP Code: 92627-2501
Phone: (949) 515-5170

Authorized Official

Name: STACEY GILLIS, D.C.
Title: PRESIDENT
Phone: (949) 515-5170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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