| NPI | 1063718138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEWART B FRESH Owner 985-259-7774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1405) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2013-12-23 |