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General NPI Number Information
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NPI Number | 1225329295
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Entity Type | Organization
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Legal Business Name | ERBS ORGANIC WELLNESS CENTER
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Dates
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Enumeration Date | 04/26/2011
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 7519 175TH ST UNIT 1E
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City | TINLEY PARK
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State | IL
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Zip | 60477-6929
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Country | US
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Telephone | 708-466-1085
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Fax |
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Provider Business Mailing Address
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Address Line | 6420 W 127TH ST SUITE 106
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-2269
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Country | US
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Telephone | 708-629-0708
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Fax |
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Authorized Official
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Title or Position | DR
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Name | DR. LAWRENCE J ERBS
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Credential | DC
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Telephone | 708-629-0708
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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 | 038.011637
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License Number State | IL
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