| NPI | 1518059336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRA ISBELL Contractor 312-415-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038010168) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038010201) |
| 225100000X Physical Therapist (Licence: IL 70013088) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |