| NPI | 1295910305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY RACHELLE BLUE Office Manager 920-731-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 2991-012) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2012-04-05 |