| NPI | 1891482519 |
|---|---|
| Doing Business As | MYODETOX |
| Entity Type | Organization |
| Authorized Contact | SCOTT MARCACCIO Assistant Secretary 917-327-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-04-21 |