| NPI | 1518215714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNINE OGLE Owner 708-365-8281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172P00000X Naprapath (Licence: IL 181000115) |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2013-02-27 |