=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356707970
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARA MCCARTNEY DOCTOR OF CHIROPRACTIC INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2016
-----------------------------------------------------
Last Update Date | 01/12/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5525 CANOGA AVE #317
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367-6643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-914-4952
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5525 CANOGA AVE #317
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367-6643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KARA MCCARTNEY
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 818-914-4952
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 32681
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------