Provider Demographics
NPI:1770191066
Name:SALT OF THE EARTH
Entity Type:Organization
Organization Name:SALT OF THE EARTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMOLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-281-7044
Mailing Address - Street 1:850 S MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3227
Mailing Address - Country:US
Mailing Address - Phone:847-281-7044
Mailing Address - Fax:
Practice Address - Street 1:850 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3227
Practice Address - Country:US
Practice Address - Phone:847-281-7044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Single Specialty