Healthcare Provider Details

I. General information

NPI: 1346253572
Provider Name (Legal Business Name): VERONICA LEE DOMBROSKI-SPEAKS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13936 STATE HIGHWAY 97
PETERSBURG IL
62675-6018
US

IV. Provider business mailing address

62 N SHORE DR
PETERSBURG IL
62675-9778
US

V. Phone/Fax

Practice location:
  • Phone: 217-632-4455
  • Fax: 217-632-4345
Mailing address:
  • Phone: 217-632-7856
  • Fax: 217-632-4345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: