| Organization Name: | MILL VALLEY FAMILY CHIROPRACTIC |
| NPI Number: | 1043433063 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESPER LUNDBAEK (SOLE PROPRIETOR) |
| Mailing Address: | 591 Redwood Hwy Ste 2300 Mill Valley |
| State: | CA US |
| Postal Code: | 949416032 |
| Phone Number: | 4153899000 |
| Fax Number: | 4153897912 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 06/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 22400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |