| NPI | 1497337216 |
|---|---|
| Doing Business As | THE SOURCE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | JORDAN FAIRLEY Chiropractor 510-328-1381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2021-04-21 |