Most Relevant Information
Provider Data
| NPI Number: | 1003032814 |
| Provider Name: | SANDRA ELIZABETH NYSTROM D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 14175 |
Most Important Dates
| Enumeration Date: | 04/18/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2226 BATAAN RD
REDONDO BEACH
CA
902781405
Practice Location Phone/Fax
| Phone: | 3103744013 |
| Fax: | 3105428349 |
Provider Mailing Location
2226 BATAAN RD
REDONDO BEACH
CA
902781405
Provider Mailing Phone/Fax
| Phone: | 3103744013 |
| Fax: | 3105428349 |