| NPI | 1952835613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY PECK Owner 769-216-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MS 1238) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MS 1236) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |