| NPI | 1932411873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL LEE COOPER Owner 715-808-0716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 1664-012) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2017-10-26 |