| NPI | 1497165773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN OUELLETTE Owner 678-297-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: GA CHIR005929) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2014-05-07 |