Healthcare Provider Details

I. General information

NPI: 1477597565
Provider Name (Legal Business Name): DAVID ERIC BEMIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/25/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BELLE STREET SUITE C
ALTON IL
62002-6117
US

IV. Provider business mailing address

418 BELLE STREET SUITE C
ALTON IL
62002-6117
US

V. Phone/Fax

Practice location:
  • Phone: 618-465-6500
  • Fax: 866-460-6962
Mailing address:
  • Phone: 618-465-6500
  • Fax: 866-460-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number038006296
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: