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Organization
SMALLIE CHIROPRACTIC INC.
Active
Organization
SMALLIE CHIROPRACTIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON DAVID SMALLIE DC (OWNER CHIROPRACTOR)
(209) 957-9601
Entity
Organization
Contact information
Practice address
2027 GRAND CANAL BLVD STE 21, STOCKTON, CA 95207-6650
(209) 957-9601
Mailing address
2027 GRAND CANAL BLVD STE 21, STOCKTON, CA 95207-6650
(209) 957-9601
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC11659
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GDC000630
MEDI-CAL GROUP #
CA
01
—
ZZZ33842Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
03/15/2007
Last updated
02/05/2013
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