Provider Demographics
NPI:1699808451
Name:PREMIER CHIROPRACTIC
Entity Type:Organization
Organization Name:PREMIER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SHERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-666-6685
Mailing Address - Street 1:426 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3909
Mailing Address - Country:US
Mailing Address - Phone:530-666-6685
Mailing Address - Fax:530-666-6676
Practice Address - Street 1:426 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3909
Practice Address - Country:US
Practice Address - Phone:530-666-6685
Practice Address - Fax:530-666-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28625111N00000X
CADC28912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27262ZMedicare ID - Type UnspecifiedGROUP MEDICARE #
CAX99393Medicare UPIN