| 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 |