NPI | 1316010143 |
---|---|
Entity Type | Organization |
Authorized Contact | GEORGE WAYNE BLAKE Billing Manager 813-818-7499 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7630) |
Enumeration Date | 2006-11-17 |
Last Update Date | 2013-01-24 |