| NPI | 1962977579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RIDER Owner 903-821-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |