| NPI | 1164894895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHETT ETHAN BOGACZ Manager/Owner 941-210-3637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11394) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2021-08-02 |