Ideal Health And Weight Loss, INC.
Chiropractor in O'Fallon, IL. Organization (NPI-2).
NPI number1285874875
StatusActive
Last updated in NPPESDec 5, 2014
Details
- NPI
- 1285874875
- Entity type
- Organization (NPI-2)
- Legal business name
- Ideal Health And Weight Loss, INC.
- Organization subpart
- No
- Enumeration date
- Feb 23, 2009
- Last updated
- Dec 5, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 038008443 | IL | Yes |
Practice location
810 West Hwy 50O'Fallon, IL 62269-6636
Phone 618-406-9920
Mailing address
810 West Hwy 50O'Fallon, IL 62269-6636
Phone 618-406-9920
Authorized official
Jason Christopher Walker
Owner
6184069920
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