Individual
DR. DENNIS M WAZAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
231 BLUE RAVINE RD, SUITE 200, FOLSOM, CA 95630-3893
(916) 985-7575
Mailing address
231 BLUE RAVINE RD, SUITE 200, FOLSOM, CA 95630-3893
(916) 985-7575
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC26511
CA
111NX0100X
Occupational Health Chiropractor
DC26511
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ62244Z
BLUE SHIELD
CA
Enumeration date
12/23/2006
Last updated
12/27/2007
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