Provider Demographics
NPI:1386947216
Name:FINE, JOSHUA DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:FINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 E BARNETT RD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8672
Mailing Address - Country:US
Mailing Address - Phone:541-245-9544
Mailing Address - Fax:541-245-9574
Practice Address - Street 1:1910 E BARNETT RD
Practice Address - Street 2:SUITE #103
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8672
Practice Address - Country:US
Practice Address - Phone:541-245-9544
Practice Address - Fax:541-245-9574
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor