| NPI | 1124113220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DUANE HENRY Owner/Director 605-334-6656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: SD 980) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-04-01 |