NPI | 1396873162 |
---|---|
Entity Type | Organization |
Authorized Contact | BRADLEY DARIN WALTERS President 505-899-0708 |
Organization Subpart ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NM 1354) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2020-08-22 |