Healthcare Provider Details

I. General information

NPI: 1245205004
Provider Name (Legal Business Name): BRYAN D CASE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34A MAIN ST
WINTERS CA
95694-1723
US

IV. Provider business mailing address

34A MAIN ST
WINTERS CA
95694-1723
US

V. Phone/Fax

Practice location:
  • Phone: 530-795-4211
  • Fax: 530-795-0241
Mailing address:
  • Phone: 530-795-4211
  • Fax: 530-795-0241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number23221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: