| NPI | 1013310085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHON QUALLS Chiropractic Physician/Member 505-334-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 2109) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2014-10-03 |