| NPI | 1275729659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK KERWIN LASHER President 309-661-4325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 036-099905) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-11-22 |