| NPI | 1497093504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EICKERT Owner 563-212-3215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 038011653) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011653) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-08-05 |