| NPI | 1255774964 |
|---|---|
| Former Legal Business Name | HEALTHSOURCE OF SPANISH FORT LLC |
| Entity Type | Organization |
| Authorized Contact | MEREDITH ADDESS Owner 251-625-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2019-07-26 |