Healthcare Provider Details

I. General information

NPI: 1881621704
Provider Name (Legal Business Name): CORT CHRISTOPHER EHLMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 ANTELOPE RD STE A5
SACRAMENTO CA
95842-3900
US

IV. Provider business mailing address

5800 ANTELOPE RD STE A5
SACRAMENTO CA
95842-3900
US

V. Phone/Fax

Practice location:
  • Phone: 916-729-0311
  • Fax: 916-729-3890
Mailing address:
  • Phone: 916-729-0311
  • Fax: 916-729-3890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number016357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: