NPI | 1083828511 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHEN MARK LOVELL Owner 239-541-0005 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 5345) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2007-05-10 |
Last Update Date | 2020-08-22 |