| NPI | 1154457869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL DAVID BROCCOLI President 401-351-6390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: RI DCP00204) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-10-16 |