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General NPI Number Information
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NPI Number | 1760183560
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Entity Type | Organization
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Legal Business Name | LIMITLESS MEDICAL
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 4440 BROADWAY ST STE 12
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City | QUINCY
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State | IL
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Zip | 62305-9147
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Country | US
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Telephone | 217-242-0420
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Fax |
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Provider Business Mailing Address
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Address Line | 4440 BROADWAY ST STE 12
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City | QUINCY
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State | IL
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Zip | 62305-9147
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Country | US
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Telephone | 217-242-0420
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JUSTIN FELSMAN
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Credential | DC
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Telephone | 217-242-0420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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