Organization Name: | KENT G CARLOMAGNO A PROF CHIROPRACTIC CORP |
NPI Number: | 1467519488 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENT GENE CARLOMAGNO (CHIROPRACTOR) |
Mailing Address: | 710 C St Suite 12 San Rafael |
State: | CA US |
Postal Code: | 949013857 |
Phone Number: | 4157217520 |
Fax Number: | 4167217535 |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 01/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 08/05/2008 |
NPI Reactivation Date: | 01/05/2011 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 15882 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |