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General NPI Number Information
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NPI Number | 1104060292
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Entity Type | Organization
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Legal Business Name | AMY R RUBIO CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 3065 PORTER ST STE 105
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City | SOQUEL
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State | CA
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Zip | 95073-2231
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Country | US
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Telephone | 831-345-2035
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 EL MAR CT
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City | WATSONVILLE
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State | CA
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Zip | 95076-6694
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Country | US
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Telephone | 831-345-2035
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. AMY RYANNE RUBIO
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Credential | DC
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Telephone | 831-345-2035
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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 | DC30675
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License Number State | CA
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