| NPI | 1366465213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY WILLIAM SHAW Owner/President 217-224-3935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 042007976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 042007976) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-03-10 |