| NPI | 1710988068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JOE SHALLOW President/Director 313-277-3766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301004116) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-08-22 |