Healthcare Provider Details

I. General information

NPI: 1366477994
Provider Name (Legal Business Name): DAN A MEFFORD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 W WASHINGTON ST
PITTSFIELD IL
62363-1353
US

IV. Provider business mailing address

813 W WASHINGTON ST P.O. BOX 7
PITTSFIELD IL
62363-1353
US

V. Phone/Fax

Practice location:
  • Phone: 217-285-5641
  • Fax:
Mailing address:
  • Phone: 217-285-5641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38-003654
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: