| NPI | 1396060711 |
|---|---|
| Doing Business As | INTEGRATIVE SPORTS AND WELLNESS MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | BRYAN JEPSON President 512-263-9961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2010-03-30 |