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General NPI Number Information
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NPI Number | 1891728135
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Entity Type | Organization
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Legal Business Name | FREEDOM CHIROPRACTIC SERVICES MIDWEST PC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 2707 W ALGONQUIN RD
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City | ALGONQUIN
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State | IL
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Zip | 60102-9400
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Country | US
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Telephone | 910-641-0425
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Fax | 910-640-2054
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Provider Business Mailing Address
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Address Line | 620 S MADISON ST
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City | WHITEVILLE
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State | NC
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Zip | 28472-4130
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Country | US
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Telephone | 910-641-0425
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Fax | 910-640-2054
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A. WEBSTER
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Credential | D.C.
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Telephone | 910-641-0425
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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 | NC1459
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License Number State | NC
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