Healthcare Provider Details

I. General information

NPI: 1124313689
Provider Name (Legal Business Name): ALTERNATIVE SOLUTIONS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4989 OLD US 50
AVISTON IL
62216
US

IV. Provider business mailing address

P.O. BOX 633 4989 OLD US 50
AVISTON IL
62216
US

V. Phone/Fax

Practice location:
  • Phone: 618-228-7722
  • Fax:
Mailing address:
  • Phone: 618-228-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038010599
License Number StateIL

VIII. Authorized Official

Name: DR. AMBERLEE N PRITCHARD
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 618-228-7722