| NPI | 1770846230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MARIE ROBERTSON Billing Department 636-925-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.003850) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2013-05-15 |