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General NPI Number Information
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NPI Number | 1851804090
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Entity Type | Organization
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Legal Business Name | ERIC J DICKERSON
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 352 PROVIDENCE MINE RD
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City | NEVADA CITY
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State | CA
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Zip | 95959-2977
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Country | US
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Telephone | 530-955-0065
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Fax | 530-509-2089
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Provider Business Mailing Address
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Address Line | 124 CLYDESDALE CT STE K
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City | GRASS VALLEY
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State | CA
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Zip | 95945-9540
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Country | US
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Telephone | 530-955-0065
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Fax | 530-200-8865
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC J DICKERSON
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Credential | D.C
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Telephone | 815-245-5146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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