| NPI | 1972751956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN THOMAS DIEFENBACH Owner Chiropractor 618-795-6910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2008026720) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-12-03 |