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General NPI Number Information
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NPI Number | 1235667288
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Entity Type | Organization
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Legal Business Name | PLANET CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 432 N WEBER RD
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City | ROMEOVILLE
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State | IL
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Zip | 60446-4945
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Country | US
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Telephone | 815-372-0170
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Fax | 815-372-0171
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Provider Business Mailing Address
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Address Line | 432 N WEBER RD
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City | ROMEOVILLE
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State | IL
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Zip | 60446-4945
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Country | US
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Telephone | 815-372-0170
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Fax | 815-372-0171
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL MOYNIHAN
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Credential |
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Telephone | 815-372-0170
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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 | 038012185
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License Number State | IL
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