| NPI | 1497276745 |
|---|---|
| Doing Business As | FUNCTIONAL MEDICINE VALPARAISO |
| Entity Type | Organization |
| Authorized Contact | GARY TENNANT Owner 708-275-4698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002905A) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-21 |