| NPI | 1093874968 | 
|---|---|
| Former Legal Business Name | BABY BOOMER CHIROPRACTIC | 
| Entity Type | Organization | 
| Authorized Contact | SUSAN M. CARTER Owner 239-784-8895 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9228) | 
| Enumeration Date | 2006-12-07 | 
| Last Update Date | 2011-10-01 |