NPI | 1033541495 |
---|---|
Entity Type | Organization |
Authorized Contact | RUSSELL ANTICO Owner 443-259-0235 |
Organization Subpart ? | No |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: MD S01939) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2013-08-07 |