| NPI | 1821736042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CARROLL Office Rep 833-789-3227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-05-26 |