| NPI | 1235872094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HUSEBOE Pd 954-410-2999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-08-01 |