| NPI | 1366940645 |
|---|---|
| Doing Business As | PROVASOLI CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | MARK DEN HARTOG Owner/Chiropractor 515-822-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 60741817) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |