| NPI | 1922738962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA YOUNGBLOOD Manager 682-270-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NR0400X |
| 111NX0100X Chiropractor, Occupational Health | |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |