NPI | 1003117052 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDRE WULLAERT Owner 817-284-1235 |
Organization Subpart ? | No |
Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: TX 6533) |
Enumeration Date | 2010-11-08 |
Last Update Date | 2010-11-08 |