| NPI | 1558520585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W MATHESIE Bod 954-755-1434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |