Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0116948038 | AZ |
NPI | 1003946641 |
---|---|
Provider Name | Dr. Cheryll Straub |
First Address | Tucson, AZ 85712-1184 |
Second Address | Tucson, AZ 85712-1184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |