| NPI | 1194005157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD E RIDDLE Member 864-680-3704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: SC 3484) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2011-08-23 |