| NPI | 1124138003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GREGORY WEINMAN Treasurer 309-369-0434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-010333) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-12-10 |