| NPI | 1578062899 |
|---|---|
| Doing Business As | HEALTHSOURCE OF BALLWIN |
| Entity Type | Organization |
| Authorized Contact | CHAD JOSEPH DOLES President/Owner 636-220-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2020-12-16 |