| NPI | 1013388479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALY KHYM BUENTIPO ZARZUELA Owner / Provider 210-599-9570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2016-01-29 |