| NPI | 1336326404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MICHAEL RENNER Manager 618-604-6923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038011084) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2008-01-30 |