Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 32048 | CA |
NPI | 1235498379 |
---|---|
Provider Name | Dr. Terrance Addison Ashton-Boyd |
First Address | Santa Ana, CA 92704-7263 |
Second Address | Orange, CA 92866-3426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2012 |
Last Update Date | 11/06/2013 |