Provider Demographics
NPI:1467446781
Name:EAST YOLO CHIROPRACTIC CENTER, INC
Entity Type:Organization
Organization Name:EAST YOLO CHIROPRACTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-371-7882
Mailing Address - Street 1:2939 W CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:W SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-2910
Mailing Address - Country:US
Mailing Address - Phone:916-371-7882
Mailing Address - Fax:916-371-7897
Practice Address - Street 1:2939 W CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:W SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-2910
Practice Address - Country:US
Practice Address - Phone:916-371-7882
Practice Address - Fax:916-371-7897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15942111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty