| NPI | 1396955415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HANSEN President 1847-998-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IL 060008720) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 060008720) |
| 111NX0800X Chiropractor, Orthopedic (Licence: IL 060008720) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-09-11 |