| NPI | 1780862318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW FARIS Owner 810-233-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2022-05-24 |