Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC36077 | CA |
NPI | 1093395881 |
---|---|
Provider Name | Kirsten Anastasia Sparley |
First Address | Whittier, CA 90604-4051 |
Second Address | Whittier, CA 90604-4051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2021 |
Last Update Date | 14/04/2021 |