| 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 |