| NPI | 1275954737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BEACH President 309-828-3415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038005425) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038005425) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |