| NPI | 1093022600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS MYRACLE CLARK Chiropractic Physician 731-885-0461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN 2356) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2013-08-19 |