| NPI | 1598572562 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MITCHELL GERARD FASSAERT Chiropractor 602-437-2225 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor | 
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation | 
| Enumeration Date | 2024-12-13 | 
| Last Update Date | 2024-12-13 |