| NPI | 1376680124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM AMMERMAN Administrator 760-949-1489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC21523) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC27666) |
| 207X00000X Orthopaedic Surgery (Licence: CA A36514) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |