NPI | 1629275821 |
---|---|
Entity Type | Organization |
Authorized Contact | SITSADAPHONE PENG PHETCHAMPHONE Owner 630-833-3799 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
Enumeration Date | 2007-06-29 |
Last Update Date | 2020-08-22 |