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General NPI Number Information
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NPI Number | 1174791735
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Entity Type | Organization
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Legal Business Name | ABSOLUTE WELLNESS & REHAB, INC.
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 720 S RAND RD
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City | LAKE ZURICH
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State | IL
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Zip | 60047-2467
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Country | US
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Telephone | 847-438-0055
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Fax | 847-438-8649
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Provider Business Mailing Address
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Address Line | 720 S RAND RD
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City | LAKE ZURICH
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State | IL
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Zip | 60047-2467
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Country | US
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Telephone | 847-438-0055
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Fax | 847-438-8649
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDY J HORNING
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Credential | DC, CCSP
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Telephone | 847-438-0055
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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 |
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License Number State | IL
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