| NPI | 1336460385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI KAY DIECKMANN Owner 618-973-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: IL 038.011634) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2010-06-14 |