| NPI | 1114520087 |
|---|---|
| Former Legal Business Name | KENNETH NILSSON |
| Entity Type | Organization |
| Authorized Contact | KENNETH NILSSON Owner 949-677-8423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |