| NPI | 1356708978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BRUNKHORST Owner, Manager 618-978-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038010170) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2015012151) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |