| NPI | 1629198908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER ENRIQUE MENDOZA Chiropractor 516-213-4610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: NY 010611) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2007-07-23 |