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General NPI Number Information
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NPI Number | 1720278583
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Entity Type | Organization
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Legal Business Name | REDDEL CHIROPRACTIC INC.
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 1398 SOLANO AVE
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City | ALBANY
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State | CA
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Zip | 94706-1855
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Country | US
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Telephone | 510-558-8258
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Fax |
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Provider Business Mailing Address
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Address Line | 1398 SOLANO AVE
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City | ALBANY
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State | CA
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Zip | 94706-1855
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Country | US
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Telephone | 510-558-8258
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELLE REDDEL
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Credential | D.C.
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Telephone | 510-558-8258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | DC 24834
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License Number State | CA
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