| NPI | 1518794700 |
|---|---|
| Doing Business As | PERFORMANCE SPORT & SPINE |
| Entity Type | Organization |
| Authorized Contact | ERIK JOSEPH NOTHOLD Chiopractor 217-440-5635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-12-18 |