| NPI | 1316163751 |
|---|---|
| Former Legal Business Name | GONSTEAD SPINE INSTITUTE PC |
| Entity Type | Organization |
| Authorized Contact | JOSE LARA Chiropractor 602-973-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5303) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2019-06-17 |