| NPI | 1952945214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY FAVA MADDEN Owner/Chiropractor 619-738-0933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |