| NPI | 1497989479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY E GREEN Chairman Of The Board 800-404-6050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2023-06-27 |