Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 28535 | CA |
NPI | 1780787713 |
---|---|
Provider Name | Laura Anne Sheehan |
First Address | Tiburon, CA 94920 |
Second Address | San Francisco, CA 94122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |