| NPI | 1518779248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE SHIPP Mbr 903-218-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |