Healthcare Provider Details

I. General information

NPI: 1801994975
Provider Name (Legal Business Name): ALLAN SUTHERLAND ROSS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SUNRISE AVE STE 115
ROSEVILLE CA
95661-4583
US

IV. Provider business mailing address

755 SUNRISE AVE STE 115
ROSEVILLE CA
95661-4583
US

V. Phone/Fax

Practice location:
  • Phone: 916-786-6055
  • Fax: 916-786-6452
Mailing address:
  • Phone: 916-786-6055
  • Fax: 916-786-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC24580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: