| NPI | 1104186667 |
|---|---|
| Doing Business As | LIFERX |
| Entity Type | Organization |
| Authorized Contact | SHAWN CHRISTOPHER SNIDER Owner 309-622-3002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 036.110856) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-17 |