| NPI | 1417363276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACH SYVRUD Manager 210-315-1582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX f2412) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 12285) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |