NPI | 1295061596 |
---|---|
Entity Type | Organization |
Authorized Contact | DEVON TYLER MCGILLEM Owner/Doctor 317-270-9500 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002450A) |
Enumeration Date | 2009-10-22 |
Last Update Date | 2009-10-22 |