| NPI | 1982859526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY R SHEPPARD Owner 858-350-6290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 16059) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 15278) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |