NPI | 1487775060 |
---|---|
Entity Type | Organization |
Authorized Contact | TARYN A DECICCO Owner 847-577-4455 |
Organization Subpart ? | No |
Primary Taxonomy | 133N00000X Nutritionist (Licence: IL 164002932) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198000665) |
Enumeration Date | 2007-04-02 |
Last Update Date | 2020-08-22 |