| NPI | 1952613770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRY VAN ROMER Sole Member 864-888-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 1287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 29413) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2011-04-21 |