| NPI | 1356351464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY A CHIDESTER Owner/Operator 513-524-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 2292) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: OH 07243) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2014-05-28 |