Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC0147160 | CA |
NPI | 1780719690 |
---|---|
Provider Name | Erich Ross Parks |
First Address | Auburn, CA 95603-9021 |
Second Address | Auburn, CA 95603-9021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |