| 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 |