| NPI | 1225568975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT COUILLARD President 339-927-4379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3387) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22574) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2019-06-26 |