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General NPI Number Information
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NPI Number | 1043433162
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Entity Type | Organization
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Legal Business Name | HULSEBUS AND GEHLSEN CHIROPRACTIC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 630 TERRA WEST DR
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City | FREEPORT
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State | IL
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Zip | 61032-4536
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Country | US
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Telephone | 815-235-7858
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Fax | 815-235-7913
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Provider Business Mailing Address
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Address Line | 630 TERRA WEST DR
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City | FREEPORT
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State | IL
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Zip | 61032-4536
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Country | US
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Telephone | 815-235-7858
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Fax | 815-235-7913
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Authorized Official
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Title or Position | VICE PRESIDENT DIRECTOR
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Name | DR. JEFFREY P GEHLSEN
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Credential | D.C.
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Telephone | 815-235-7858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 060005547
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License Number State | IL
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