| NPI | 1710424213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANNER JOHN RODRIGUEZ Owner/President 817-708-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 13344) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |