| NPI | 1134252471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY GEORGE WATT Doctor/Owner 321-253-8511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7835) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH8029) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2009-10-20 |