| NPI | 1023655867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK EARL NORSWORTHY Owner 302-595-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 111N00000X Chiropractor | |
| 152W00000X Optometrist | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2021-05-27 |