| NPI | 1245050194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA JURIS Member 224-587-0129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |