| NPI | 1689692287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MICHAEL DORRITY Owner 618-236-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038009706) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070008604) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |