NPI | 1780839944 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH LAWRENCE INCHIOSTRO Owner 636-300-8089 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2000172545) |
Enumeration Date | 2008-12-01 |
Last Update Date | 2008-12-01 |