| NPI | 1851751838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT ILG REICHELT Chiropractor 631-682-1544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition |
| 111NR0400X Chiropractor, Rehabilitation | |
| 111NX0100X Chiropractor, Occupational Health | |
| 111NX0800X Chiropractor, Orthopedic | |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |