NPI | 1144855461 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON SABOL Provider 661-834-1544 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 111N00000X Chiropractor |
Enumeration Date | 2020-03-06 |
Last Update Date | 2020-03-06 |