| NPI | 1447790597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM FREDERICK VON BARGEN Owner 407-450-6991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL OS9286) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH10928) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS9286) | |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-07 |