Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 18824 | CA |
NPI | 1164649323 |
---|---|
Provider Name | Alice D. Howell |
First Address | Burbank, CA 91505 |
Second Address | Burbank, CA 91505-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |