Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC18807 | CA |
NPI | 1255573168 |
---|---|
Provider Name | Dr. Victoria M Gorney Tutak |
First Address | Grass Valley, CA 95945-5724 |
Second Address | Grass Valley, CA 95945-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2009 |
Last Update Date | 19/03/2015 |