| NPI | 1154666386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WILLIAM LOUIS Principal Owner 224-235-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038012084) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-11-28 |