Provider Demographics
NPI:1720217409
Name:APPLIED CHIROPRACTIC SOLOTIONS
Entity Type:Organization
Organization Name:APPLIED CHIROPRACTIC SOLOTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-836-3597
Mailing Address - Street 1:404 W GRANT LINE RD
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-2550
Mailing Address - Country:US
Mailing Address - Phone:209-836-3597
Mailing Address - Fax:209-833-7793
Practice Address - Street 1:404 W GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-2550
Practice Address - Country:US
Practice Address - Phone:209-836-3597
Practice Address - Fax:209-833-7793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty