Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08002720A | IN |
NPI | 1003242017 |
---|---|
Provider Name | Lauren Warner |
First Address | Syracuse, IN 46567-0091 |
Second Address | Syracuse, IN 46567-1984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2013 |
Last Update Date | 23/09/2013 |