Healthcare Provider Details

I. General information

NPI: 1154516284
Provider Name (Legal Business Name): ROBERT LAYZELL ARMSTRONG III D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2125 WYLIE DR STE 1
MODESTO CA
95355-3847
US

IV. Provider business mailing address

2125 WYLIE DR STE 1
MODESTO CA
95355-3847
US

V. Phone/Fax

Practice location:
  • Phone: 209-527-2273
  • Fax: 209-527-2263
Mailing address:
  • Phone: 209-527-2273
  • Fax: 209-527-2263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: