Provider Demographics
NPI:1073732467
Name:ROYSE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ROYSE CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:ROYSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-243-0889
Mailing Address - Street 1:1435 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1026
Mailing Address - Country:US
Mailing Address - Phone:530-243-0889
Mailing Address - Fax:530-243-4959
Practice Address - Street 1:1435 MARKET ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1026
Practice Address - Country:US
Practice Address - Phone:530-243-0889
Practice Address - Fax:530-243-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03203ZMedicare ID - Type UnspecifiedGROUP ID