Provider Demographics
NPI:1013149327
Name:FARMER, ATHENA CHRISTINE
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:CHRISTINE
Last Name:FARMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 NORTH E STREET
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401
Mailing Address - Country:US
Mailing Address - Phone:909-884-6677
Mailing Address - Fax:909-884-9496
Practice Address - Street 1:123 NORTH E STREET
Practice Address - Street 2:LALAMA CHIROPRACTIC OFFICES
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401
Practice Address - Country:US
Practice Address - Phone:909-884-6677
Practice Address - Fax:909-884-9496
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist