| NPI | 1386235307 |
|---|---|
| Other Name | MOUNTAINSIDE COMMUNITY WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | BONNY R PAYNE Owner 802-565-0424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2023-11-05 |