NPI | 1558798058 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY M RYDER Owner 225-766-9788 |
Organization Subpart ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: LA 1594) |
Enumeration Date | 2013-09-30 |
Last Update Date | 2014-04-07 |