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General NPI Number Information
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NPI Number | 1306811336
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Entity Type | Organization
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Legal Business Name | CAPITOL CHIROMED, LTD.
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 3631 S 6TH ST SUITE B
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City | SPRINGFIELD
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State | IL
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Zip | 62703-4777
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Country | US
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Telephone | 217-391-5446
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Fax | 217-585-6720
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Provider Business Mailing Address
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Address Line | 3631 S 6TH ST SUITE B
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City | SPRINGFIELD
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State | IL
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Zip | 62703-4777
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Country | US
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Telephone | 217-391-5446
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Fax | 217-585-6720
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DR. MICHELLE OLIVER
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Credential | DC
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Telephone | 217-391-5446
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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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