| NPI | 1407395353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARLAND BRENT BOECKING CEO 512-371-7478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |