Provider Demographics
NPI:1265782718
Name:ERWIN CHIROPRACTIC INC.
Entity type:Organization
Organization Name:ERWIN CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-973-0623
Mailing Address - Street 1:900 FULTON AVE
Mailing Address - Street 2:102
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4500
Mailing Address - Country:US
Mailing Address - Phone:916-973-0623
Mailing Address - Fax:916-973-0338
Practice Address - Street 1:900 FULTON AVE
Practice Address - Street 2:102
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4500
Practice Address - Country:US
Practice Address - Phone:916-973-0623
Practice Address - Fax:916-973-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty