| 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 |