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General NPI Number Information
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NPI Number | 1922316868
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Entity Type | Organization
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Legal Business Name | THE VALIANT JACOBS CHIROPRACTIC CORP
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 3 POPPY LN
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City | SAN CARLOS
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State | CA
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Zip | 94070-1533
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Country | US
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Telephone | 650-218-8648
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Fax | 650-594-4981
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Provider Business Mailing Address
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Address Line | 2901 K STREET. SUITE 120C
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City | SACRAMENTO
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State | CA
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Zip | 95816
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Country | US
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Telephone | 916-448-1770
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Fax | 916-448-3015
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RITCH VALIANT JACOBS
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Credential | D.C.
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Telephone | 650-218-8648
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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 | DC25246
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License Number State | CA
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