| NPI | 1639472251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ANTHONY DESTEFANO Owner/President 210-495-0086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 101Y00000X Counselor |
| 174400000X Specialist | |
| 207L00000X Anesthesiology | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2010-12-21 |