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General NPI Number Information
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NPI Number | 1598767576
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Entity Type | Organization
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Legal Business Name | BURCH CHIROPRACTIC LTD
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 510 N MAIN ST
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City | LEWISTOWN
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State | IL
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Zip | 61542-1143
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Country | US
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Telephone | 309-547-2343
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Fax |
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Provider Business Mailing Address
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Address Line | 510 N MAIN ST
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City | LEWISTOWN
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State | IL
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Zip | 61542-1143
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Country | US
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Telephone | 309-547-2343
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | JAMES V BURCH
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Credential | DC
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Telephone | 309-547-2343
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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 | 038002991
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License Number State |
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