Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 14533 | CA |
NPI | 1013041433 |
---|---|
Provider Name | Dr. Marcia Rae Zicafoose |
First Address | El Cajon, CA 92019-1629 |
Second Address | Escondido, CA 92027-3068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |