| NPI | 1679146419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORVILLE A. ANTONIO Chiropractor 920-818-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2025-06-20 |