NPI | 1053036764 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE MARCHESE Credentialing Manager 214-205-4995 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 111NI0900X Chiropractor Internist |
Enumeration Date | 2022-10-05 |
Last Update Date | 2022-10-05 |