Provider Demographics
NPI:1245446400
Name:DAVIS CHIROPRACTIC
Entity type:Organization
Organization Name:DAVIS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:831-757-8240
Mailing Address - Street 1:100 E ROMIE LN STE 4
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3167
Mailing Address - Country:US
Mailing Address - Phone:831-757-8240
Mailing Address - Fax:831-757-1622
Practice Address - Street 1:100 E ROMIE LN STE 4
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3167
Practice Address - Country:US
Practice Address - Phone:831-757-8240
Practice Address - Fax:831-757-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC17090OtherCHIRO LICENSE
CA=========OtherTIN