Healthcare Provider Details

I. General information

NPI: 1497840102
Provider Name (Legal Business Name): BRIAN M ORMOND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 SPROWEL CREEK ROAD
GARBERVILLE CA
95542
US

IV. Provider business mailing address

353 SPROWEL CREEK ROAD
GARBERVILLE CA
95542
US

V. Phone/Fax

Practice location:
  • Phone: 707-923-9343
  • Fax:
Mailing address:
  • Phone: 707-923-9343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC16791
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: