| NPI | 1992572986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE D RICHARDSON-SICRE Registered Agent 571-220-1362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation |
| Enumeration Date | 2023-12-08 |
| Last Update Date | 2023-12-08 |