| NPI | 1437249158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK KOMESHAK Owner 618-236-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008047) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070011807) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-02-25 |