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General NPI Number Information
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NPI Number | 1053646257
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Entity Type | Organization
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Legal Business Name | WELBORN DC PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 1269 PLEASANT GROVE BLVD SUITE 190
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City | ROSEVILLE
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State | CA
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Zip | 95747-5885
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Country | US
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Telephone | 530-401-6512
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Fax | 877-372-6670
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Provider Business Mailing Address
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Address Line | 1269 PLEASANT GROVE BLVD SUITE 190
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City | ROSEVILLE
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State | CA
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Zip | 95747-5885
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Country | US
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Telephone | 530-401-6512
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Fax | 877-372-6670
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHARINA CHRISTINE WELBORN
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Credential | D.C.
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Telephone | 530-401-6512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B01061
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 29-303
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License Number State | CA
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