Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 31029 | CA |
NPI | 1053648048 |
---|---|
Provider Name | Dr. Howard Scott Vance |
First Address | Pomona, CA 91767-1200 |
Second Address | Pomona, CA 91767-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2009 |
Last Update Date | 11/11/2009 |