Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC12296 | CA |
NPI | 1134299761 |
---|---|
Provider Name | Dr. Charlene Beddard Thorburn |
First Address | Burbank, CA 91506-1311 |
Second Address | Burbank, CA 91506-1311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |