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General NPI Number Information
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NPI Number | 1801198973
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Entity Type | Organization
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Legal Business Name | NICOLE G. PAXTON, DC, SC
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 521 S 24TH ST
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City | QUINCY
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State | IL
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Zip | 62301-5730
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Country | US
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Telephone | 217-222-4363
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Fax |
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Provider Business Mailing Address
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Address Line | 521 S 24TH ST
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City | QUINCY
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State | IL
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Zip | 62301-5730
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Country | US
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Telephone | 217-222-4363
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. NICOLE GEORGETTE PAXTON
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Credential | D.C.
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Telephone | 217-222-4363
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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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