Provider Demographics
NPI:1588369433
Name:ENDRES, ABBY (DC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:ENDRES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 MARGUERITE AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1121
Mailing Address - Country:US
Mailing Address - Phone:763-229-2043
Mailing Address - Fax:
Practice Address - Street 1:1724 MARGUERITE AVE
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1121
Practice Address - Country:US
Practice Address - Phone:763-229-2043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor