Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3096 | TX |
NPI | 1003838475 |
---|---|
Provider Name | Dr. Michele K Gerard |
First Address | Austin, TX 78759-8661 |
Second Address | Austin, TX 78759-8661 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 08/07/2007 |