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NPI Code Detail

MEDICARE: NATALIE SYLVIA OTOYA STUDENT

MEDICARE:   NATALIE SYLVIA OTOYA  STUDENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor4297NC
2111N00000XChiropractor3701SC
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1043458557
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE SYLVIA OTOYA STUDENT
Provider Business Mailing Address
First Line : 2327 SHENANDOAH AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205-6025
Country : US
Telephone Number : 703-593-1906
Fax Number :
Provider Business Practice Location Address
First Line : 2327 SHENANDOAH AVE.
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205
Country : US
Telephone Number : 703-593-1906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2009
Last Update Date : 07/24/2015

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Directions to “ NATALIE SYLVIA OTOYA STUDENT” Practice Location

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