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 |