| NPI | 1285627521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY CLARK WILLIAMS Owner 701-683-4582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ND 562) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 640) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2007-09-25 |