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General NPI Number Information
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NPI Number | 1750384509
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Entity Type | Organization
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Legal Business Name | BORRE CHIROPRACTIC, LTD.
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 2S610 STATE ROUTE 59
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City | WARRENVILLE
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State | IL
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Zip | 60555-1459
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Country | US
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Telephone | 630-393-2828
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Fax | 630-393-0292
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Provider Business Mailing Address
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Address Line | 2S610 STATE ROUTE 59 UNIT 9
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City | WARRENVILLE
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State | IL
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Zip | 60555-1459
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Country | US
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Telephone | 630-393-2828
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Fax | 630-393-0292
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMANDA BETH BORRE
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Credential | D.C.
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Telephone | 630-393-2828
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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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