| NPI | 1144331034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER DANIEL JOHANSEN President 757-422-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104001208) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-12-07 |