| NPI | 1750667945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M FULLMER Owner 301-576-4023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: MD S03493) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2011-11-01 |