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General NPI Number Information
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NPI Number | 1821311689
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Entity Type | Organization
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Legal Business Name | NASH UPPER CERVICAL CHIROPRACTIC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 1118 N LARKIN AVE
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City | JOLIET
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State | IL
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Zip | 60435-3456
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Country | US
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Telephone | 815-714-2271
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Fax |
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Provider Business Mailing Address
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Address Line | 1118 N LARKIN AVE
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City | JOLIET
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State | IL
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Zip | 60435-3456
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Country | US
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Telephone | 815-714-2271
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. BRETT N NASH
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Credential |
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Telephone | 815-714-2271
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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 | 038011501
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License Number State | IL
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