Provider Demographics
NPI:1972826261
Name:FOX, KATHRYN JO (DC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JO
Last Name:FOX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 ROOSEVELT RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-6180
Mailing Address - Country:US
Mailing Address - Phone:619-795-2224
Mailing Address - Fax:619-793-5517
Practice Address - Street 1:2751 ROOSEVELT RD
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6180
Practice Address - Country:US
Practice Address - Phone:619-795-2224
Practice Address - Fax:619-793-5517
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor