Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 34811 | CA |
NPI | 1285201368 |
---|---|
Provider Name | Brianna Louise Edginton |
First Address | Morgan Hill, CA 95037-3423 |
Second Address | Morgan Hill, CA 95037-2899 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2021 |
Last Update Date | 08/06/2021 |