NPI | 1558558049 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT LEE WISE President 618-244-3370 |
Organization Subpart ? | No |
Primary Taxonomy | 173000000X Legal Medicine (Licence: IL H63975) |
Additional Taxonomies | 111N00000X Chiropractor |
Enumeration Date | 2007-09-27 |
Last Update Date | 2007-09-27 |