| NPI | 1861821605 |
|---|---|
| Doing Business As | PROVIDENCE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | BRYAN MICHAEL WYLIE Owner 256-801-7227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2421) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2016-01-19 |