Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 08002607A | IN |
Y | 111N00000X | Chiropractor | 2301010165 | MI |
NPI | 1003191362 |
---|---|
Provider Name | Dr. Kate S Antoniotti |
First Address | Kalamazoo, MI 49008-1998 |
Second Address | Kalamazoo, MI 49008-1998 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2011 |
Last Update Date | 22/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201061610A | (05) | IN |
201061610A | (05) | MI |