| NPI | 1669728101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT RODNEY JACKSON Sole Member 636-614-0401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2012014933) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2012-09-21 |