NPI | 1750664215 |
---|---|
Entity Type | Organization |
Authorized Contact | DWIGHT MATTHEW MCCOY Owner/ Chiropractor 815-895-3200 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-007533) |
Enumeration Date | 2011-09-21 |
Last Update Date | 2011-09-21 |