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General NPI Number Information
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NPI Number | 1558867085
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Entity Type | Organization
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Legal Business Name | ACKERMAN CHIROPRACTIC PC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 1105 KENNEDY PL STE 5
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City | DAVIS
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State | CA
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Zip | 95616-1272
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Country | US
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Telephone | 530-650-5265
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Fax |
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Provider Business Mailing Address
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Address Line | 949 PONDEROSA PL
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City | DAVIS
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State | CA
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Zip | 95616-2140
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Country | US
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Telephone | 707-832-9623
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL DAVID ACKERMAN
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Credential | DC
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Telephone | 707-832-9623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 34069
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License Number State | CA
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