| NPI | 1699179010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN RENEE FAZIO Owner / Manager 901-335-6006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-011411) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2015-10-27 |