| NPI | 1184197618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CHARLES STRACK Owner 678-480-6075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition |
| 111NR0200X Chiropractor, Radiology | |
| 111NR0400X | |
| 111NT0100X Chiropractor, Thermography | |
| 111NX0100X Chiropractor, Occupational Health | |
| 111NX0800X Chiropractor, Orthopedic | |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |