| NPI | 1871741389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN SMITH Member 404-788-6140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: GA 041961) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA 008268) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |