NPI | 1043507940 |
---|---|
Doing Business As | PERFORMANCE WELLNESS SOUTH |
Entity Type | Organization |
Authorized Contact | JACOB ROBERTS Owner 317-791-1511 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Enumeration Date | 2011-06-30 |
Last Update Date | 2011-06-30 |