| NPI | 1326690728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE MICHAEL KOUKLES President/Chiropractor 586-876-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |