| NPI | 1922295948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA I WALLIE Owner 410-349-2727 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD 01998) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 01760) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2008-07-30 |