Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 32206 | CA |
NPI | 1225301518 |
---|---|
Provider Name | Dr. Darci Robertson |
First Address | Los Alamos, CA 93440-0835 |
Second Address | Solvang, CA 93463-2283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 16/02/2012 |