Organization Name: | MICHAEL G RIDGEWAY DC INC |
NPI Number: | 1780602672 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL G RIDGEWAY (OWNER PRESIDENT) |
Mailing Address: | 777 Farmers Lane Santa Rosa |
State: | CA US |
Postal Code: | 95405 |
Phone Number: | 7075442400 |
Fax Number: | 7075445203 |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 15617 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |