| NPI | 1295416618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVIANNE WAITHE Chiropractic Doctor/AO 443-622-9429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation |
| Additional Taxonomies | 247200000X |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| 111NX0800X Chiropractor, Orthopedic | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2023-09-15 |