| NPI | 1184842650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M DORRITY Managing Employee 618-398-9716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008365) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038010101) |
| 111N00000X Chiropractor (Licence: IL 038010608) | |
| 225100000X Physical Therapist (Licence: IL 070008604) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |