Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0104002011 | VA |
NPI | 1003896317 |
---|---|
Provider Name | Karen A Cerwinski |
First Address | New Canton, VA 23123 |
Second Address | New Canton, VA 23123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 28/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
287625 | ANTHEM BCBS (01) | VA |
U88291 | (02) |