| NPI | 1164163366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DENNISON HESS Member 772-492-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-05-17 |