| NPI | 1770225443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW BENJAMIN DEWILD Owner 563-484-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice |
| Additional Taxonomies | 225700000X Massage Therapist |
| 1041C0700X Social Worker, Clinical | |
| 111N00000X Chiropractor | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |