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General NPI Number Information
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NPI Number | 1184278525
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Entity Type | Organization
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Legal Business Name | LIVING ROOTS CORPORATION
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 900 FULTON AVE STE 150
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City | SACRAMENTO
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State | CA
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Zip | 95825-4517
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Country | US
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Telephone | 916-488-8307
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Fax | 916-244-0564
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Provider Business Mailing Address
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Address Line | 900 FULTON AVE STE 150
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City | SACRAMENTO
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State | CA
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Zip | 95825-4517
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Country | US
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Telephone | 916-488-8307
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Fax | 916-244-0564
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Authorized Official
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Title or Position | CEO/CHIROPRACTOR
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Name | DR. LILIANA ULLOA-JIMENEZ
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Credential | DC
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Telephone | 916-296-8615
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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 |
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License Number State |
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