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General NPI Number Information
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NPI Number | 1366622375
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Entity Type | Organization
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Legal Business Name | CARTERVILLE CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 108 N DIVISION ST
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City | CARTERVILLE
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State | IL
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Zip | 62918-1245
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Country | US
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Telephone | 618-985-9555
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Fax | 618-985-9576
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Provider Business Mailing Address
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Address Line | 108 N DIVISION ST
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City | CARTERVILLE
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State | IL
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Zip | 62918-1245
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Country | US
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Telephone | 618-985-9555
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Fax | 618-985-9576
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERICH JOHN SNYDER
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Credential | D.C.
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Telephone | 618-985-9555
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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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