Provider Demographics
NPI:1871628644
Name:UNITED CHIROPRACTIC
Entity type:Organization
Organization Name:UNITED CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, QME
Authorized Official - Phone:916-632-3211
Mailing Address - Street 1:6661 STANFORD RANCH RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2683
Mailing Address - Country:US
Mailing Address - Phone:916-632-3211
Mailing Address - Fax:916-632-7194
Practice Address - Street 1:6661 STANFORD RANCH RD
Practice Address - Street 2:SUITE G
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2683
Practice Address - Country:US
Practice Address - Phone:916-632-3211
Practice Address - Fax:916-632-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24808111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty