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General NPI Number Information
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NPI Number | 1447509864
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Entity Type | Organization
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Legal Business Name | CORE WELLNESS CHIROPRACTIC AND ANTI-AGING CENTRE
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 21 N 2ND ST
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City | GENEVA
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State | IL
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Zip | 60134-2224
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Country | US
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Telephone | 630-208-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 21 N 2ND ST
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City | GENEVA
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State | IL
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Zip | 60134-2224
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Country | US
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Telephone | 630-208-1110
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. PATRICIA LYNN ZANELLI
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Credential | D.C.
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Telephone | 630-208-1110
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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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