| NPI | 1821438854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY ELLEDGE Sole Member 405-703-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 3835) |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2013-07-05 |