| NPI | 1598926958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY SAMUEL BOURNE President/Treasurer 386-789-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 9261) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |