| NPI | 1104141795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNFER WADDELL Owner 949-860-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 19445) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 22884) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2010-04-07 |