| NPI | 1548508732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BENEDICT Owner 915-591-0680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: TX 8790) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1189796) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2015-05-08 |