| NPI | 1821547688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB LISERIO TORRES Owner 210-468-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2020-04-08 |