Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 33550 | CA |
NPI | 1043577554 |
---|---|
Provider Name | Brandon Barnette |
First Address | Santa Ana, CA 92706-2704 |
Second Address | Santa Ana, CA 92706-2704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 30/06/2016 |