| NPI | 1174358915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN LAINE President 917-803-3818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NI0900X Chiropractor, Internist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-12-23 |