| NPI | 1972477867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE VALLEY Owner 111-111-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-10-02 |
| Last Update Date | 2025-10-02 |