Provider Demographics
NPI:1447463047
Name:DAVIDSON, JOSHUA AARON (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:AARON
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:JOSHUA
Other - Middle Name:AARON
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHIROPRACTOR
Mailing Address - Street 1:9381 E STOCKTON BLVD
Mailing Address - Street 2:LIBERTY CENTER II SUITE 219
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5068
Mailing Address - Country:US
Mailing Address - Phone:916-670-1883
Mailing Address - Fax:916-670-1889
Practice Address - Street 1:9381 E STOCKTON BLVD
Practice Address - Street 2:LIBERTY CENTER II SUITE 219
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5068
Practice Address - Country:US
Practice Address - Phone:916-670-1883
Practice Address - Fax:916-670-1889
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC28363OtherSTATE LICENSE #