| NPI | 1588009880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE JOHNSON Doctor/Owner 760-449-7641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CO CHR.0006922) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0006922) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |