NPI | 1548565351 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN DALE HASENCLEVER Owner/President 479-621-9006 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 1705) |
Enumeration Date | 2011-01-26 |
Last Update Date | 2011-01-26 |