| NPI | 1063522837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN RAY BROCK President 505-740-3688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 1493) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: HI 1052) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |