| NPI | 1922420256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K HENRY Owner 662-890-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2016-03-08 |