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General NPI Number Information
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NPI Number | 1750584256
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Entity Type | Organization
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Legal Business Name | A C CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 11 S LA GRANGE RD STE 204
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City | LA GRANGE
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State | IL
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Zip | 60525-2460
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Country | US
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Telephone | 708-352-8237
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Fax | 708-352-8237
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Provider Business Mailing Address
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Address Line | 11 S LA GRANGE RD STE 204
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City | LA GRANGE
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State | IL
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Zip | 60525-2460
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Country | US
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Telephone | 708-352-8237
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Fax | 708-352-8237
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. FRANK M PAINTER
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Credential | DC
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Telephone | 708-352-8237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State | IL
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