Healthcare Provider Details
I. General information
NPI: 1578819025
Provider Name (Legal Business Name): FINNEY WELLNESS CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2012
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2522 E LINCOLNWAY SUITE G
STERLING IL
61081-3058
US
IV. Provider business mailing address
2522 E LINCOLNWAY SUITE G
STERLING IL
61081-3058
US
V. Phone/Fax
- Phone: 815-626-6630
- Fax: 815-626-6796
- Phone: 815-626-6630
- Fax: 815-626-6796
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
THOMAS
D
FINNEY
Title or Position: OWNER
Credential: DC
Phone: 815-626-6630