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 |