NPI | 1689018681 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANE DONALD WHITELEY President 772-777-2836 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Additional Taxonomies | 207P00000X Emergency Medicine |
207Q00000X Family Medicine | |
133N00000X Nutritionist | |
Enumeration Date | 2013-04-20 |
Last Update Date | 2013-05-16 |