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General NPI Number Information
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NPI Number | 1710442488
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Entity Type | Organization
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Legal Business Name | VBL HOLDINGS, LTD.
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 1521 W WALNUT ST STE D
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City | JACKSONVILLE
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State | IL
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Zip | 62650-1153
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Country | US
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Telephone | 217-243-4333
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Fax | 844-892-4533
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Provider Business Mailing Address
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Address Line | 117 W POINT DR
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City | JACKSONVILLE
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State | IL
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Zip | 62650-9590
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Country | US
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Telephone | 209-658-9995
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Fax | 844-892-4533
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL G LYELL
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Credential | DC
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Telephone | 209-658-9995
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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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