| NPI | 1629249909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON STAFFORD Owner 727-797-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME97457) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH8146) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |