Provider Demographics
NPI:1558582007
Name:SYMES, MICHAEL J (DC, PC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SYMES
Suffix:
Gender:M
Credentials:DC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 NORTH MARKET BLVD.
Mailing Address - Street 2:SUTIE 9
Mailing Address - City:SACRMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834
Mailing Address - Country:US
Mailing Address - Phone:916-285-9277
Mailing Address - Fax:916-928-7221
Practice Address - Street 1:1431 NORTH MARKET BLVD.
Practice Address - Street 2:SUTIE 9
Practice Address - City:SACRMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834
Practice Address - Country:US
Practice Address - Phone:916-285-9277
Practice Address - Fax:916-928-7221
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA252770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0252771Medicare ID - Type Unspecified