Healthcare Provider Details

I. General information

NPI: 1902088263
Provider Name (Legal Business Name): SPURLOCK CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 MELVILLE RD
GARBERVILLE CA
95542-3409
US

IV. Provider business mailing address

441 MELVILLE RD
GARBERVILLE CA
95542-3409
US

V. Phone/Fax

Practice location:
  • Phone: 707-923-2880
  • Fax: 707-923-2881
Mailing address:
  • Phone: 707-923-2880
  • Fax: 707-923-2881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC28858
License Number StateCA

VIII. Authorized Official

Name: MS. JACQUITA M SNODGRASS
Title or Position: OFFICE MANAGER
Credential:
Phone: 707-923-2880