MEDICARE: DR. DONNA LEE LAFLAMME

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	111NR0400X	Rehabilitation Chiropractor	21735	CA

General Provider Information

NPI Number	:	1750528725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONNA LEE LAFLAMME

Provider Business Mailing Address
First Line	:	2110 MARIN AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-2433
Country	:	US
Telephone Number	:	510-526-6002
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 MARIN AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-2433
Country	:	US
Telephone Number	:	510-526-6002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	01/13/2009

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