Organization
ISA5417, LLC
Active
Other names
PIHELP
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA YURAIMA CORRIE (MANAGING MEMBER)
(210) 249-4949
Entity
Organization
Contact information
Practice address
154 E MYRTLE AVE STE 100, MURRAY, UT 84107-4850
(801) 210-5050
(801) 210-5050
Mailing address
14439 NW MILITARY HWY STE 108-449, SHAVANO PARK, TX 78231-1646
(210) 249-4949
(210) 249-4949
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
11/09/2022
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