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General NPI Number Information
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NPI Number | 1629505995
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Entity Type | Organization
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Legal Business Name | DAVIS CHIROPRACTIC PC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9480 BASELINE RD
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City | ALTA LOMA
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State | CA
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Zip | 91701-5822
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Country | US
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Telephone | 909-285-4561
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Fax |
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Provider Business Mailing Address
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Address Line | 9480 BASELINE RD
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City | ALTA LOMA
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State | CA
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Zip | 91701-5822
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Country | US
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Telephone | 909-285-4561
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRITTANY NICOLE TREADWAY
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Credential | DC
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Telephone | 909-210-0630
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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 | 33632
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License Number State | CA
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