| NPI | 1710164348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY A EDWARDS Owner 815-432-4277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2012-08-08 |