| NPI | 1306085428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ANN WILLARD Authorized Official 309-762-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038010770) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2025-12-19 |