| NPI | 1487008124 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PAMELA JEAN MOBARAK Office Manager 904-425-4546 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 266621) | 
| Enumeration Date | 2016-04-19 | 
| Last Update Date | 2016-04-19 |