| NPI | 1598193302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER P BRANDON Registered Agent 239-770-3446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH10987) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2024-04-25 |