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General NPI Number Information
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NPI Number | 1558571034
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Entity Type | Organization
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Legal Business Name | KOHLMEIER CHIROPRACTIC THERAPY
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1329 NORTH ROUTE 3
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City | WATERLOO
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State | IL
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Zip | 62298
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Country | US
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Telephone | 618-939-3033
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Fax | 618-282-3971
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Provider Business Mailing Address
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Address Line | 1329 NORTH ROUTE 3
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City | WATERLOO
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State | IL
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Zip | 62298
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Country | US
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Telephone | 618-939-3033
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Fax | 618-282-3971
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. WAYNE LEWIS KOHLMEIER
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Credential | DC
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Telephone | 618-939-3033
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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 | 383378
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License Number State | IL
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