| 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 |