| NPI | 1588070528 |
|---|---|
| Doing Business As | ATHLETIC REPUBLIC-THE WOODLANDS |
| Entity Type | Organization |
| Authorized Contact | DERRICK RAYMER Director Of Sports Performance 832-791-5954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: TX 12247) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2014-07-10 |