Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 7977 | AZ |
N | 111NR0400X | Rehabilitation Chiropractor | 4664 | AZ |
NPI | 1366695413 |
---|---|
Provider Name | Dr. Rachel Joy Novak |
First Address | Vail, AZ 85641-6658 |
Second Address | Tucson, AZ 85715-3802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2008 |
Last Update Date | 01/11/2008 |