NPI | 1306418678 |
---|---|
Doing Business As | THE SOURCE CHIROPRACTIC |
Entity Type | Organization |
Authorized Contact | DYLLON MAWN Owner/President 561-876-2157 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Enumeration Date | 2021-07-15 |
Last Update Date | 2023-11-06 |