| NPI | 1912584616 |
|---|---|
| Former Legal Business Name | BACK TO EDEN |
| Entity Type | Organization |
| Authorized Contact | TUNYESSE M MURPHY Owner 708-224-7163 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2021-05-11 |