| NPI | 1316061344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A ADDANTE Vice President 719-539-9493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CO 5493) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |