| NPI | 1215116942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS MARK LUNA Doctor/VP 1773-427-0820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 038-010483) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |