| NPI | 1467851105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R CARROLL Office Rep 352-942-1204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |