| NPI | 1164761268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KINDRED Owner 309-214-9950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IL 036086752) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |