Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 11773 | CA |
NPI | 1629130711 |
---|---|
Provider Name | Dr. Greg Nolan Mcnabb |
First Address | Scotts Valley, CA 95066-3428 |
Second Address | Scotts Valley, CA 95066-3428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |