NPI | 1124307301 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL TIMOTHY DONOHUE Owner/Operator/President 815-394-0309 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.011639) |
Enumeration Date | 2011-08-05 |
Last Update Date | 2011-08-30 |