| NPI | 1629063458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ELIZABETH COUNTERMAN Business Manager 262-925-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 3590) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038009230) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2008-09-18 |