| NPI | 1780067132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD A BLACK Member 808-524-8588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 261QP2000X Clinic/Center Physical Therapy | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |