| NPI | 1750270468 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DARCY DEBRA DANE Manager 239-380-5596  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology | 
| Additional Taxonomies | 261Q00000X Clinic/Center | 
| Enumeration Date | 2025-06-30 | 
| Last Update Date | 2025-06-30 |