| NPI | 1245650589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRENT MIRANOV Owner/Chiropractor 580-540-9630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 4061) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2014-04-25 |