| NPI | 1518273911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA LEIGH DAVIS Proprietor 636-219-9664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MO 038011404) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2010-08-23 |