| NPI | 1255697165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN G WUBBEN President/Secretary/Treasurer 605-275-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SD 1175) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |