| NPI | 1699321703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH W. SIEGEL Owner 708-790-2776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2022-08-10 |