| NPI | 1316342124 |
|---|---|
| Doing Business As | FUNCTIONAL SPINE AND SPORT |
| Entity Type | Organization |
| Authorized Contact | CARL ANTHONY NOTTOLI President 269-267-7937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038012174) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |