| NPI | 1619291879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN RUSSO Owner 504-913-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |