Organization
PREMIER HEALTH OF PLACERVILLE INC
Active
Other names
Premier Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
CHERILYN BOLTON (OFFICE MANAGER)
(530) 622-3536
Entity
Organization
Contact information
Practice address
1980 BROADWAY, PLACERVILLE, CA 95667-9001
(530) 622-3536
(530) 622-3538
Mailing address
1980 BROADWAY, PLACERVILLE, CA 95667-9001
(530) 622-3536
(530) 622-3536
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
15474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932345410
GROUP NPI
CA
Enumeration date
04/09/2012
Last updated
05/29/2013
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