Provider Demographics
NPI:1841009065
Name:SUNDSTROM CHIROPRACTIC CLINIC INC
Entity type:Organization
Organization Name:SUNDSTROM CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-685-6380
Mailing Address - Street 1:9295 E STOCKTON BLVD STE 10
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4096
Mailing Address - Country:US
Mailing Address - Phone:916-685-6380
Mailing Address - Fax:
Practice Address - Street 1:9295 E STOCKTON BLVD STE 10
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4096
Practice Address - Country:US
Practice Address - Phone:916-685-6380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty