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General NPI Number Information
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NPI Number | 1184964249
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Entity Type | Organization
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Legal Business Name | AIRROSTI GREAT LAKES LLC
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 911 CENTRAL PKWY N SUITE 300
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City | SAN ANTONIO
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State | TX
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Zip | 78232-5052
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Country | US
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Telephone | 180-040-4605
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Fax | 210-477-4956
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Provider Business Mailing Address
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Address Line | 911 CENTRAL PKWY N SUITE 300
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City | SAN ANTONIO
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State | TX
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Zip | 78232-5052
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Country | US
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Telephone | 180-040-4605
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Fax | 210-477-4956
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Authorized Official
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Title or Position | VICE PRESIDENT OF CLINICAL DEVELOPM
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Name | DR. CHRISTOPHER GLEN CATO
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Credential | D.C.
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Telephone | 18004046050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 9554
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License Number State | TX
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