| NPI | 1366682965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRIGUE BOSSOUS Manager 407-403-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2022-07-21 |