| NPI | 1356462915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEON PRUSKI Owner 936-295-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 5291) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 5291) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: TX 1036200) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2010-11-03 |