Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC 21168A | CA |
NPI | 1194872309 |
---|---|
Provider Name | Dr. Robert L. Wilkinson |
First Address | Brea, CA 92821-3118 |
Second Address | Brea, CA 92821-3118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |