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General NPI Number Information
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NPI Number | 1811281728
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Entity Type | Organization
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Legal Business Name | OZBOURN CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 101 TRANSCRAFT DR
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City | ANNA
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State | IL
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Zip | 62906-2114
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Country | US
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Telephone | 618-833-2179
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Fax | 618-438-5119
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Provider Business Mailing Address
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Address Line | 101 TRANSCRAFT DR
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City | ANNA
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State | IL
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Zip | 62906-2114
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Country | US
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Telephone | 618-833-2179
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Fax | 618-438-5119
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS RAY MCGUIRE
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Credential | D.C.
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Telephone | 618-435-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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