NPI | 1962647792 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN JAY FULLER President 708-705-9494 |
Organization Subpart ? | No |
Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: IL 038010329) |
Enumeration Date | 2008-12-08 |
Last Update Date | 2008-12-08 |