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General NPI Number Information
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NPI Number | 1740409879
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Entity Type | Organization
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Legal Business Name | JON R. NICHOLS CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 545 LOS COCHES ST SUITE 104
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City | MILPITAS
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State | CA
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Zip | 95035-5483
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Country | US
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Telephone | 408-945-1233
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Fax | 408-956-8812
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Provider Business Mailing Address
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Address Line | 545 LOS COCHES ST SUITE 104
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City | MILPITAS
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State | CA
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Zip | 95035-5483
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Country | US
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Telephone | 408-945-1233
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Fax | 408-956-8812
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON ROSS NICHOLS
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Credential | DC
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Telephone | 408-945-1233
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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 | DC25361
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License Number State | CA
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