Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH12236 | FL |
NPI | 1003327529 |
---|---|
Provider Name | Yeisy Tome |
First Address | Hollywood, FL 33020-7711 |
Second Address | Hollywood, FL 33020-7711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2017 |
Last Update Date | 07/07/2020 |