Provider Demographics
NPI:1679003248
Name:ATKINSON CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:ATKINSON CHIROPRACTIC INC.
Other - Org Name:COMPLETE CARE CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-749-1346
Mailing Address - Street 1:151 N SUNRISE AVE STE 1413
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2934
Mailing Address - Country:US
Mailing Address - Phone:916-749-1346
Mailing Address - Fax:916-749-1347
Practice Address - Street 1:151 N SUNRISE AVE STE 1413
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2934
Practice Address - Country:US
Practice Address - Phone:916-749-1346
Practice Address - Fax:916-749-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:2017-07-03
Deactivation Code:
Reactivation Date:2017-08-15
Provider Licenses
StateLicense IDTaxonomies
CADC30983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942453733OtherNPI NUMBER