Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 34673 | CA |
NPI | 1457998262 |
---|---|
Provider Name | Rachel Anne Selnick |
First Address | Santa Cruz, CA 95060-3559 |
Second Address | Santa Cruz, CA 95060-3559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2019 |
Last Update Date | 30/11/2019 |