NPI | 1205341930 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL MARK TUTTLE Chiropractic Physician 678-334-1504 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL 12257) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL 14564) |
Enumeration Date | 2017-12-04 |
Last Update Date | 2018-01-22 |