Provider Demographics
NPI:1184839607
Name:GLADIEUX, TODD ARCHER (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ARCHER
Last Name:GLADIEUX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 PLUMAS ST STE 101
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3453
Mailing Address - Country:US
Mailing Address - Phone:530-821-5865
Mailing Address - Fax:530-673-4388
Practice Address - Street 1:1215 PLUMAS ST STE 101
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3453
Practice Address - Country:US
Practice Address - Phone:530-821-5865
Practice Address - Fax:530-673-4388
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0157081Medicare ID - Type Unspecified