| NPI | 1770601874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE IRA TUCKER Owner 302-838-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C2004133) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F1-0000484) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2014-04-16 |