| NPI | 1174231500 |
|---|---|
| Former Legal Business Name | DEEPLY ROOTED CHIROPRACTIC, LLC |
| Entity Type | Organization |
| Authorized Contact | RACHAEL LINDSEY Owner 920-450-1655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-15 |