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NPI 1407314560

NPI 1407314560 : JESSICA MEAGAN FLORES DC : RIVERSIDE, CA

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General NPI Number Information
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    NPI Number           |    1407314560
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    Entity Type          |    Individual 
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    Provider Name        |    JESSICA MEAGAN FLORES DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/07/2019
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    Last Update Date     |    03/07/2019
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Provider Practice Location Address
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    Address Line         |    19069 VAN BUREN BLVD STE 110 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92508-9170
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    Country              |    US
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    Telephone            |    951-444-1746
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14655 WOOD RD 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92508-8995
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    34455
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    License Number State |    CA
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