| NPI | 1205513322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY WALKE Practice Manager 352-515-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |