Healthcare Provider Details

I. General information

NPI: 1073080198
Provider Name (Legal Business Name): SACRAMENTO SPINAL SPECIALISTS AN OLIVER CHIROPRACTIC CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2018
Last Update Date: 10/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARDEN WAY STE. 1
SACRAMENTO CA
95825-2000
US

IV. Provider business mailing address

3000 ARDEN WAY STE 1
SACRAMENTO CA
95825-2000
US

V. Phone/Fax

Practice location:
  • Phone: 916-488-5560
  • Fax: 916-488-5597
Mailing address:
  • Phone: 916-488-5560
  • Fax: 916-488-5597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DAN MITCHELL OLIVER
Title or Position: CHIROPRACTOR/DOCTOR
Credential: DC
Phone: 916-488-5600