Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 31030 | CA |
NPI | 1376793802 |
---|---|
Provider Name | Dr. Erica D Witter |
First Address | Lomita, CA 90717-1473 |
Second Address | Lomita, CA 90717-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2008 |
Last Update Date | 20/09/2008 |