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General NPI Number Information
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NPI Number | 1841009065
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Entity Type | Organization
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Legal Business Name | SUNDSTROM CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 9295 E STOCKTON BLVD STE 10
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City | ELK GROVE
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State | CA
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Zip | 95624-4096
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Country | US
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Telephone | 916-685-6380
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Fax |
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Provider Business Mailing Address
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Address Line | 9295 E STOCKTON BLVD STE 10
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City | ELK GROVE
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State | CA
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Zip | 95624-4096
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Country | US
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Telephone | 916-685-6380
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHAD SUNDSTROM
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Credential | DC
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Telephone | 916-685-6380
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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 |
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License Number State |
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