Provider Demographics
NPI:1437583903
Name:DICKERSON, ERIC JOSEF (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSEF
Last Name:DICKERSON
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 1:352 PROVIDENCE MINE RD
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2977
Mailing Address - Country:US
Mailing Address - Phone:530-955-0065
Mailing Address - Fax:530-200-8865
Practice Address - Street 1:352 PROVIDENCE MINE RD
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2977
Practice Address - Country:US
Practice Address - Phone:530-955-0065
Practice Address - Fax:530-200-8865
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012492111N00000X
CA33998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor