NPI | 1609207968 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENT ALAN TIDWELL President 256-383-5772 |
Organization Subpart ? | No |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: AL 1932) |
Enumeration Date | 2013-12-11 |
Last Update Date | 2022-07-21 |