| NPI | 1316402720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIA DAVIS Billing 800-716-3537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |