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General NPI Number Information
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NPI Number | 1013384460
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Entity Type | Individual
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Provider Name | JOEL JOSEPH DICKSON D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 11294 COLOMA RD
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City | GOLD RIVER
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State | CA
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Zip | 95670-4486
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Country | US
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Telephone | 916-778-6523
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Fax |
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Provider Business Mailing Address
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Address Line | 11294 COLOMA RD STE H
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City | GOLD RIVER
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State | CA
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Zip | 95670-4486
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Country | US
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Telephone | 916-778-6523
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 33379
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License Number State | CA
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