NPI | 1578967188 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIGDET BRASFIELD Owner 618-877-1644 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: IL 038009646) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038009646) |
Enumeration Date | 2014-10-13 |
Last Update Date | 2014-10-13 |