| NPI | 1245423748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J BLY Chiropractor/Owner 309-661-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038005081) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |