| NPI | 1386905826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN DUNCAN Director 601-878-6945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00504900) |
| Additional Taxonomies | 111NR0400X (Licence: NJ MC04730) |
| 111N00000X Chiropractor (Licence: NJ 25MZ00020100) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |