Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 32089 | CA |
NPI | 1003185265 |
---|---|
Provider Name | Dr. Jacalyn Reane Amrine |
First Address | Redding, CA 96001-2929 |
Second Address | Redding, CA 96001-2929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2011 |
Last Update Date | 17/12/2011 |