| NPI | 1730305913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK DAVID WALLERY President 773-283-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 042-006675) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |