Organization
ANTOVICH CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD JAY ANTOVICH D.C. (PRESIDENT)
(916) 684-4100
Entity
Organization
Contact information
Practice address
9156 ELK GROVE BLVD, ELK GROVE, CA 95624-2013
(916) 684-4100
(916) 684-5299
Mailing address
9156 ELK GROVE BLVD, ELK GROVE, CA 95624-2013
(916) 684-4100
(916) 684-5299
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
DC0209030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0209030
MEDICARE PTAN
CA
Enumeration date
04/11/2012
Last updated
04/11/2012
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