| 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 |