| NPI | 1750059614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL RUITENBEEK Owner 404-901-2908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-09-03 |