NPI | 1588927008 |
---|---|
Entity Type | Organization |
Authorized Contact | KAHVEH ALIZADEH Owner 970-402-5639 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WY 723) |
Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: WY 723) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2012-06-22 |