| NPI | 1841763562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEA SUB SONG Director 410-465-3074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2021-10-15 |