| NPI | 1336316629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON LESLIE STEPHENSON Shareholder 706-596-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA GA005828) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |