| NPI | 1558737031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA WILCZAK Manager 904-513-3954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: AK 100077) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |