| NPI | 1063797694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN G. HEATON Doctor 410-750-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD 1468 PT) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 1467 PT) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2013-01-28 |