Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 3552 | CO |
NPI | 1043383425 |
---|---|
Provider Name | Dr. Janet Kerin |
First Address | Castle Rock, CO 80104-2409 |
Second Address | Castle Rock, CO 80104-2409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46432 | (02) | CO |