| NPI | 1205512969 |
|---|---|
| Doing Business As | DR. TRAVIS WOOD MUNNERLYN |
| Entity Type | Organization |
| Authorized Contact | TRAVIS WOOD MUNNERLYN Owner/President 773-677-0937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |