| NPI | 1295790830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGIL LEE POTTS President 618-262-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IL 042-617767) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2014-08-01 |