| NPI | 1265575765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EZRA EDGERTON Owner 704-434-9130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: NC 1735) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2018-05-23 |