Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC15612 | CA |
NPI | 1215026588 |
---|---|
Provider Name | Mr. John H Hunt |
First Address | Glendora, CA 91741-3358 |
Second Address | Glendora, CA 91741-3358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC15612 | (02) | CA |