| NPI | 1740586833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ASHLEY President 1515-755-5855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 133799) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-02-07 |