| NPI | 1790520500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R HOODY Owner 929-639-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-06-25 |