| NPI | 1689731531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL THOMAS COSTA Owner 803-802-8601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor Orthopedic (Licence: SC 3081) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |