| NPI | 1891005369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD TEPPER President 386-310-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH8484) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH10046) |
| 111N00000X Chiropractor (Licence: FL CH10229) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2012-02-18 |