| NPI | 1538825369 |
|---|---|
| Doing Business As | CHIRO858 |
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL BOURGOUIN President/CEO 760-846-1831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-16 |