| NPI | 1679743843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ROBERT DIEDRICH Owner Chiropractor 317-578-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002182A) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-04 |