Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | DC28456 | CA |
NPI | 1538311618 |
---|---|
Provider Name | Jennifer Anne Boyke |
First Address | Porter Ranch, CA 91326-4120 |
Second Address | Porter Ranch, CA 91326-4120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 21/10/2008 |