| NPI | 1619141678 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | JEFFERY DALE REEDER Owner/President 719-384-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 4251) |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2008-04-21 |