| NPI | 1164606737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RICHARD MENGES Sole Owner 410-638-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD 01933) |
| Additional Taxonomies | 111NR0400X (Licence: MD 01933) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2016-01-18 |