| NPI | 1205933165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE LILLIAN MARIE LEVESQUE-HARTLE Vice President 260-432-7339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: IN 08001638) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: IN 08001622) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |