Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC36241 | CA |
NPI | 1083368476 |
---|---|
Provider Name | Victoria Marie Hall |
First Address | Torrance, CA 90501-4022 |
Second Address | Manhattan Beach, CA 90266-6876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2022 |
Last Update Date | 05/02/2022 |