| NPI | 1134883861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JAMES KOCH Owner Doctor 262-784-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-10-28 |