Individual
DR. TINA MARIE ROACH-GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
7174 SANTA TERESA BLVD, STE A7, SAN JOSE, CA 95139-1350
(408) 972-5686
Mailing address
7174 SANTA TERESA BLVD, STE A7, SAN JOSE, CA 95139-1350
(408) 972-5686
(408) 972-5682
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
DC23580
CA
Other
Enumeration date
06/01/2009
Last updated
12/19/2016
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