| NPI | 1659914265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTA RICHTER Medical Biller 424-903-5526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 171100000X Acupuncturist |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-10-26 |
| Last Update Date | 2019-10-31 |