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Organization
GROOTENDORST CHIROPRACTIC PROFESSIONAL CORPORATION
Active
Organization
GROOTENDORST CHIROPRACTIC PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GROOTENDORST D.C. (OWNER)
(559) 674-8892
Entity
Organization
Contact information
Practice address
900 W YOSEMITE AVE, MADERA, CA 93637
(559) 674-8892
(559) 674-1389
Mailing address
900 W YOSEMITE AVE, MADERA, CA 93637-4555
(559) 674-8892
(559) 674-1389
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GDC000470
MEDI-CAL
CA
Enumeration date
08/05/2006
Last updated
04/16/2020
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