NPI | 1194218057 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE DAVID ROSS Owner/Clinic Director 262-676-9370 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.012686) |
Enumeration Date | 2018-06-14 |
Last Update Date | 2018-06-14 |