| NPI | 1477051878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOR MONGIE Owner Of Entity 702-417-8522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: UT 8404817-1202) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-06-25 |