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Organization
NICHOLSON CHIROPRACTIC A PROFESSIONAL CORPORATION
Active
Organization
NICHOLSON CHIROPRACTIC A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY E NICHOLSON DC (PRESIDENT, CLINIC DIRECTOR)
(209) 836-0250
Entity
Organization
Contact information
Practice address
1011 PARKER AVE., TRACY, CA 95376-3933
(209) 836-0250
(209) 836-5037
Mailing address
1011 PARKER AVE., TRACY, CA 95376-3933
(209) 836-0250
(209) 836-5037
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ60806Z
BLUE SHIELD
CA
Enumeration date
04/18/2007
Last updated
11/05/2008
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