| NPI | 1649617994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER DANIEL REYNOLDS Owner 920-728-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038012435) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |