| NPI | 1184028490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN A BRODERICK Office Manager 574-264-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08000723A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08000306A) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |