| NPI | 1609319771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SITHARI EDIRISOORIYA C.E.O. 330-501-5136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: AZ 8429) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |