Provider Demographics
NPI:1508205824
Name:DUNCAN CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:DUNCAN CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-620-8487
Mailing Address - Street 1:1459 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1304
Mailing Address - Country:US
Mailing Address - Phone:707-442-0881
Mailing Address - Fax:707-442-1084
Practice Address - Street 1:1459 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1304
Practice Address - Country:US
Practice Address - Phone:707-442-0881
Practice Address - Fax:707-442-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty