| NPI | 1962783258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DAVID LAUER President 817-812-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX K9102) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX TX4202) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |