NPI | 1548594435 |
---|---|
Former Name | HALEY DURRETTE LAUCKEM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104556746) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI L1605238) |
Enumeration Date | 2009-09-24 |
Last Update Date | 2012-10-16 |