| NPI | 1982191516 |
|---|---|
| Doing Business As | HEALTH SOURCE AMERICA'S CHIROPRACTOR |
| Entity Type | Organization |
| Authorized Contact | QUINCEY HENDERSON Owner/General Manager 832-385-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |