| NPI | 1770601080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS KULB President Of The Corporation 309-663-9424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QL0400X Clinic/Center, Lithotripsy (Licence: IL 7002512) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |