| NPI | 1912565110 |
|---|---|
| Doing Business As | FUNCTIONAL SPINE & WELLNESS |
| Entity Type | Organization |
| Authorized Contact | VIRGINIA A FATATO President 754-444-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |