| NPI | 1013925007 | 
|---|---|
| Other Name | MIKE F VANDEWALLE | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX DC2771)  | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 04589)  | 
| Enumeration Date | 2006-08-04 | 
| Last Update Date | 2016-11-02 |