Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 32656 | CA |
NPI | 1942642772 |
---|---|
Provider Name | Ms. Brooke Bargamian |
First Address | Fresno, CA 93710 |
Second Address | Fresno, CA 93710-5268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2013 |
Last Update Date | 27/04/2015 |