Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 17752 | CA |
NPI | 1295808251 |
---|---|
Provider Name | Dr. James Morrison Mccririe IV |
First Address | Grass Valley, CA 95949-6326 |
Second Address | Grass Valley, CA 95949-6326 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |