Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC17064 | CA |
NPI | 1336243534 |
---|---|
Provider Name | Betty M Clayton |
First Address | La Habra, CA 90631-5164 |
Second Address | La Habra, CA 90631-5164 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 06/05/2008 |