| NPI | 1184213993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE LYNN BROCK Owner 847-903-0503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175F00000X Naturopath |
| Additional Taxonomies | 111N00000X Chiropractor |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2021-01-15 |