| NPI | 1568632131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL KEITH LERAAEN Owner/President 602-439-5559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5735) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-03-10 |