| NPI | 1023867520 |
|---|---|
| Former Legal Business Name | NORTHERN ROOTS CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | TANNER JOSEPH KLEIN Owner 602-609-4244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-06-20 |