| NPI | 1215341664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYNE KOBRIN URBANOVICH President/Manager 239-269-9038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ AZ 7643) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2016-08-16 |