| NPI | 1154348126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY KENNETH SMITH COO 321-229-7387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH6418) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7586) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: FL OS5530) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME82389) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-08-22 |