| NPI | 1548786262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MASSEY President 773-642-9286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: PA MD458727) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2018-06-16 |