NPI | 1417356767 |
---|---|
Entity Type | Organization |
Authorized Contact | DERREK WESLEY STUDER Owner 270-307-9458 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: KY 5374) |
Additional Taxonomies | 171100000X Acupuncturist |
208100000X Physical Medicine & Rehabilitation | |
Enumeration Date | 2014-08-21 |
Last Update Date | 2014-08-21 |