| NPI | 1205256823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS TAYLOR Co Owner 217-544-3628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-011183) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-012343) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |