| NPI | 1821380890 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | VICTOR MANUEL LASA Ower 407-802-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9316) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |