NPI | 1982857561 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY BOISVERT FAIRCLOTH Chiropractor/Owner 318-448-8462 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 915) |
Enumeration Date | 2008-10-28 |
Last Update Date | 2008-11-06 |