Provider Demographics
NPI:1275670754
Name:PUTMAN CHIROPRACTIC INC
Entity Type:Organization
Organization Name:PUTMAN CHIROPRACTIC INC
Other - Org Name:TWIN CREEKS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-462-8871
Mailing Address - Street 1:584 N SUNRISE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2862
Mailing Address - Country:US
Mailing Address - Phone:916-781-2600
Mailing Address - Fax:916-781-2765
Practice Address - Street 1:584 N SUNRISE AVE
Practice Address - Street 2:STE. 130
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2862
Practice Address - Country:US
Practice Address - Phone:916-781-2600
Practice Address - Fax:916-781-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04622ZMedicare PIN