| NPI | 1568797090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHETT BERGERON Owner 678-720-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |