| NPI | 1013004514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BLACK Office Manager 937-427-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 2227) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT006681) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2022-11-09 |