NPI | 1609485887 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON P LAMARCHE Owner 815-458-2225 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
261QP3300X Clinic/Center, Pain | |
Enumeration Date | 2020-07-23 |
Last Update Date | 2020-07-23 |