| NPI | 1235679721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ALLEN RUEGGEBERG Owner 571-606-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: GA CHIR009837) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2018-11-07 |