| NPI | 1881888105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY RAY DRAKE Chiropractor 618-242-4554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 038006100) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |