Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC33155 | CA |
NPI | 1003287384 |
---|---|
Provider Name | Dr. Tamara Lee Macintyre |
First Address | Hayward, CA 94545-2801 |
Second Address | Hayward, CA 94545-2801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2015 |
Last Update Date | 13/10/2015 |