| NPI | 1215465414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ATWATER Owner 309-287-4621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2019-06-11 |