Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 17700 | CA |
N | 111NX0100X | Occupational Health | 17700 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 17700 | CA |
NPI | 1437161247 |
---|---|
Provider Name | Dr. Carol Virginia Funk Hamilton |
First Address | Wasco, CA 93280-1820 |
Second Address | Wasco, CA 93280-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |