Organization
ELENA VINCE D C A CHIROPRACTIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELENA VINCE DC (PRESIDENT - OWNER)
(415) 454-3717
Entity
Organization
Contact information
Practice address
361 3RD ST STE D, SAN RAFAEL, CA 94901-3580
(415) 454-3717
Mailing address
361 3RD ST STE D, SAN RAFAEL, CA 94901-3580
(415) 454-3717
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
18941
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0189410
MEDICARE PTAN
CA
Enumeration date
06/21/2012
Last updated
06/21/2012
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