Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | CHIR009827 | GA |
NPI | 1023527439 |
---|---|
Provider Name | Brittney Knowlton |
First Address | Eatonton, GA 31024-9536 |
Second Address | Eatonton, GA 31024-9536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2017 |
Last Update Date | 28/09/2017 |