Healthcare Provider Details

I. General information

NPI: 1427107846
Provider Name (Legal Business Name): LITCHFIELD PHYSICAL MEDICINE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N OLD ROUTE 66
LITCHFIELD IL
62056-2639
US

IV. Provider business mailing address

101 N OLD ROUTE 66
LITCHFIELD IL
62056-2639
US

V. Phone/Fax

Practice location:
  • Phone: 217-324-7755
  • Fax:
Mailing address:
  • Phone: 217-324-7755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. BRADLEY MORRIS
Title or Position: PRESIDENT
Credential: DC
Phone: 217-324-7755