| NPI | 1912560442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL BERRY Manager 469-915-4211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207R00000X Internal Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2025-04-08 |