| NPI | 1962043711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER LEE MAXEY Owner 704-300-4268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |