| NPI | 1679942395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHRISTIAN PONCE Provider/Owner 915-449-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: TX 11693) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |