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NPI Code Detail

MEDICARE: DAVIS CHIROPRACTIC INC

MEDICARE: DAVIS CHIROPRACTIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC12649CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SAT 2025OTHERCABOARD OF CHIROPRACTIC EXAMINERS- SATELLITE OFFICE CERTIFICATE
256026OTHERCACITY OF ARROYO GRANDE BUSINESS LICENSE
3C0977031OTHERCASECRETARY OF STATE-CA CORPORATION NUMBER
4363OTHERCABOARD OF CHIROPRACTIC EXAMINERS- CORPORATION CERTIFICATE NUMBER

General Provider Information

NPI Number : 1124136528
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVIS CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 880 OAK PARK BLVD
Second Line : SUITE 201
City : ARROYO GRANDE
State : CA
Zip : 93420-1821
Country : US
Telephone Number : 805-489-1477
Fax Number : 805-489-2356
Provider Business Practice Location Address
First Line : 880 OAK PARK BLVD
Second Line : SUITE 201
City : ARROYO GRANDE
State : CA
Zip : 93420-1821
Country : US
Telephone Number : 805-489-1477
Fax Number : 805-489-2356
Authorized Official
Title or Position : PRESIDENT
Name : DR. JAMES MICHAEL DAVIS
Credential : DC
Telephone Number : 805-489-1477
Provider Enumeration Date : 08/26/2006
Last Update Date : 03/20/2009

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Directions to “DAVIS CHIROPRACTIC INC ” Practice Location

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