| NPI | 1376307835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN BLACK Clinic Director 360-690-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-02-12 |