| NPI | 1083656565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MOULDS Owner 850-449-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH8429) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MM13927) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2021-03-08 |