| NPI | 1366901159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDD WATTENBARGER Owner 907-279-1838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |