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General NPI Number Information
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NPI Number | 1770792814
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Entity Type | Individual
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Provider Name | EMILY LAUREL GRACE D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 2114 N ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 916-993-3200
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Fax | 916-993-3201
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Provider Business Mailing Address
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Address Line | 7944 POCKET RD #46
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City | SACRAMENTO
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State | CA
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Zip | 95831-5704
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Country | US
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Telephone | 530-902-2105
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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 | 30566
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License Number State | CA
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