MEDICARE: WIRICK CHIROPRACTIC CARE

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
1	111N00000X	Chiropractor	DC19651	CA

General Provider Information

NPI Number	:	1821292194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WIRICK CHIROPRACTIC CARE

Provider Business Mailing Address
First Line	:	813 W NAPA ST
Second Line	:
City	:	SONOMA
State	:	CA
Zip	:	95476-6414
Country	:	US
Telephone Number	:	707-935-4330
Fax Number	:	707-935-4333

Provider Business Practice Location Address
First Line	:	813 W NAPA ST
Second Line	:
City	:	SONOMA
State	:	CA
Zip	:	95476-6414
Country	:	US
Telephone Number	:	707-935-4330
Fax Number	:	707-935-4333

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	BRIAN EUGENE WIRICK
Credential	:	D.C.
Telephone Number	:	707-935-4330

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	08/22/2020

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