MEDICARE: DR. LAURA T. SOWERS-MOKUAHI DC, LLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1043621873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. LAURA T. SOWERS-MOKUAHI DC, LLC

Provider Business Mailing Address
First Line	:	12409 RANCHO BERNARDO RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2143
Country	:	US
Telephone Number	:	858-485-8220
Fax Number	:	858-485-8222

Provider Business Practice Location Address
First Line	:	12409 RANCHO BERNARDO RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2143
Country	:	US
Telephone Number	:	858-485-8220
Fax Number	:	858-485-8222

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. LAURA T. SOWERS-MOKUAHI
Credential	:	D.C.
Telephone Number	:	858-485-8220

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	05/14/2014

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