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NPI 1811067945

NPI 1811067945 : BOZENA GRAZYNA JANCZAR DC : RIALTO, CA

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General NPI Number Information
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    NPI Number           |    1811067945
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    Entity Type          |    Individual 
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    Provider Name        |    BOZENA GRAZYNA JANCZAR DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/08/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1850 N RIVERSIDE AVE 220
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    City                 |    RIALTO
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    State                |    CA
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    Zip                  |    92376-8071
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    Country              |    US
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    Telephone            |    909-421-3003
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    Fax                  |    906-421-3092
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Provider Business Mailing Address
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    Address Line         |    1850 N RIVERSIDE AVE 220
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    City                 |    RIALTO
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    State                |    CA
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    Zip                  |    92376-8071
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    Country              |    US
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    Telephone            |    909-421-3003
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    Fax                  |    906-421-3092
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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       |    17205
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    License Number State |    CA
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