| NPI | 1598395220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GILMAN Administrator 931-801-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 208D00000X General Practice |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2024-11-07 |