Provider Demographics
NPI:1962974261
Name:MOBILIZE SPORTS CHIROPRACTIC AND MANUAL THERAPY, INC.
Entity type:Organization
Organization Name:MOBILIZE SPORTS CHIROPRACTIC AND MANUAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SILVAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-995-7243
Mailing Address - Street 1:536 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1212
Mailing Address - Country:US
Mailing Address - Phone:650-995-7243
Mailing Address - Fax:650-995-7595
Practice Address - Street 1:536 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1212
Practice Address - Country:US
Practice Address - Phone:650-995-7243
Practice Address - Fax:650-995-7595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty