| NPI | 1386512754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT CRUSE Owner 224-250-3526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |