| NPI | 1891081600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR HAAZEN GERARDUS VANDEN WYNBOOM President/Chiropractor 515-233-1866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 007397) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2012-03-19 |