| NPI | 1245480367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMETT ANDREW BLAHNIK Owner 815-708-6195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: IL 038-011886) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4247012) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2013-08-31 |