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General NPI Number Information
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NPI Number | 1255813770
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Entity Type | Organization
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Legal Business Name | GALESBURG WELLNESS SYSTEMS P.C.
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Dates
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Enumeration Date | 08/31/2018
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 575 N KELLOGG ST STE 2
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City | GALESBURG
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State | IL
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Zip | 61401-7609
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Country | US
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Telephone | 563-344-4778
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Fax | 563-344-3914
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Provider Business Mailing Address
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Address Line | 2377 CUMBERLAND SQUARE DR
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City | BETTENDORF
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State | IA
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Zip | 52722-3251
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Country | US
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Telephone | 563-359-9541
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Fax | 563-344-3914
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Authorized Official
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Title or Position | ACCOUNTS ADMINISTRATOR
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Name | JODI MARLOWE
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Credential |
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Telephone | 563-359-9541
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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 |
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