| NPI | 1356613780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT OLSON WARNER Doctor/Owner 276-963-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104556270) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556501) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |