| NPI | 1871750331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY REED SMITH Office Manager 251-621-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: AL 1140) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-09-23 |