| NPI | 1225203136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS CHARLES BAVARO Chiropractor 718-433-2399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: NY X008794) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-12-09 |