| Antovich Chiropractic Inc | |
|
9156 Elk Grove Blvd Elk Grove CA 95624-2013 | |
| (916) 684-4100 | |
| (916) 684-5299 |
| Full Name | Antovich Chiropractic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9156 Elk Grove Blvd, Elk Grove, California |
| Authorized Official Name and Position | Todd Jay Antovich (PRESIDENT) |
| Authorized Official Contact | 9166844100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antovich Chiropractic Inc 9156 Elk Grove Blvd Elk Grove CA 95624-2013 Ph: (916) 684-4100 | Antovich Chiropractic Inc 9156 Elk Grove Blvd Elk Grove CA 95624-2013 Ph: (916) 684-4100 |
| NPI Number | 1740547082 |
|---|---|
| Provider Enumeration Date | 04/11/2012 |
| Last Update Date | 04/11/2012 |
| Medicare PECOS PAC ID | 8224285598 |
|---|---|
| Medicare Enrollment ID | O20120822000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740547082 | NPI | - | NPPES |
| DC0209030 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC0209030 (California) | Primary |
| Provider Name | Todd J Antovich |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1710993951 PECOS PAC ID: 9537184312 Enrollment ID: I20051011000461 |
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