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 |