| NPI | 1427157593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E KING President 618-452-1986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038005195) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070009347) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |