| NPI | 1790018018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA CRYSTAL JOHNSON Managing Member 719-358-9837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: CO 6270) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |