| NPI | 1760415574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVERY R. DYE Billing 941-921-5741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2010-11-08 |