| 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 |