Healthcare Provider Details

I. General information

NPI: 1750314167
Provider Name (Legal Business Name): LANA S. HUTNICK D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N ABEL ST
MILPITAS CA
95035-4833
US

IV. Provider business mailing address

8 N ABEL ST
MILPITAS CA
95035-4833
US

V. Phone/Fax

Practice location:
  • Phone: 408-262-4135
  • Fax: 408-262-1379
Mailing address:
  • Phone: 408-262-4135
  • Fax: 408-262-1379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15522
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: