| NPI | 1457510497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MATHESIE Bod 954-755-1434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 111N00000X Chiropractor |
| 111NS0005X Chiropractor, Sports Physician | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |