| NPI | 1053787754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C COLGROVE Registered Agent 402-690-2027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 16107) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |