NPI | 1871819870 |
---|---|
Entity Type | Organization |
Authorized Contact | GLEN CHARLES PETTERSEN Owner 727-474-9729 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch8923) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL ch8772) |
Enumeration Date | 2010-04-15 |
Last Update Date | 2010-04-15 |