| NPI | 1679809644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN FISHER SOUTHALL President/Owner 225-274-5507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2292) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |