| NPI | 1689951055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO GONZALES Owner 269-684-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: MI 2301008841) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301008841) |
| 111N00000X Chiropractor (Licence: IN 08001868A) | |
| 111NN1001X Chiropractor, Nutrition (Licence: MI 2301008841) | |
| Enumeration Date | 2011-11-13 |
| Last Update Date | 2011-11-13 |