| NPI | 1861907198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANT PEDERSEN Owner 408-358-5086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CA DC-29419) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: CA DC-33022) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2018-02-07 |