| NPI | 1770812158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT WEGRZYN Manager 505-820-1572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NM 938) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NM 1528) |
| 171W00000X Contractor (Licence: NM 3377) | |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2009-12-16 |