| NPI | 1679826705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE CLIFFORD WALLEN Owner/Chiropractor 815-252-9783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch10733) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2016-10-25 |