NPI | 1386966885 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANNON MICHIYO RUDOLPH Vice President/Owner 352-872-5095 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9069) |
Enumeration Date | 2010-02-24 |
Last Update Date | 2010-06-11 |