| NPI | 1053616656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN RENEE NIEHAUS Executor Of Estate 217-877-8992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 344604179) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |