| NPI | 1912088683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY VAUGHN GABBERT Owner 815-455-1751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IL 042-617212) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |