| NPI | 1336555853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN DAVIDE Ownner 505-899-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: NM LMT2169) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |