| NPI | 1760438188 |
|---|---|
| Former Name | COLLEEN A MODRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8173) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CH5858) |
| 111N00000X Chiropractor (Licence: AZ 4822) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-09-04 |