NPI | 1912202292 |
---|---|
Former Name | KARA LEE MARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2021030352) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32681) |
Enumeration Date | 2011-01-18 |
Last Update Date | 2022-07-26 |