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General NPI Number Information
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NPI Number | 1760654354
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Entity Type | Organization
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Legal Business Name | HOOVER CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 440 S PRAIRIE ST
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City | BETHALTO
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State | IL
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Zip | 62010-1816
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Country | US
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Telephone | 618-377-8216
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Fax |
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Provider Business Mailing Address
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Address Line | 440 S PRAIRIE ST
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City | BETHALTO
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State | IL
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Zip | 62010-1816
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Country | US
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Telephone | 618-377-8216
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS PAUL HOOVER
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Credential | D.C.
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Telephone | 618-377-8216
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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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