| NPI | 1679083588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYREL JAMES REICHERT Owner/Operator 660-223-0199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2015044724) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2020-10-20 |