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General NPI Number Information
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NPI Number | 1295977940
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Entity Type | Organization
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Legal Business Name | UNVERZAGT FAMILY CHIROPRACTIC, LTD.
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Dates
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Enumeration Date | 03/26/2009
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 1329 S 4TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-2546
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Country | US
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Telephone | 217-544-3628
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Fax | 217-544-3627
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Provider Business Mailing Address
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Address Line | 1329 S 4TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-2546
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Country | US
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Telephone | 217-544-3628
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Fax | 217-544-3627
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN C. UNVERZAGT
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Credential | D.C.
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Telephone | 217-544-3628
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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 | 038011183
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License Number State | IL
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