| NPI | 1760774830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS CRACCHIOLO Insurance Clerk 586-739-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 2301004615) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |