| NPI | 1457005290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA CARRILLO Administrator 239-357-8462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-15 |