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General NPI Number Information
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NPI Number | 1932694759
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Entity Type | Organization
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Legal Business Name | ROCKFORD CHIROPRACTIC NEUROLOGY AND NUTRITION CENTER, LTD.
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 124 N WATER ST STE 204E
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City | ROCKFORD
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State | IL
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Zip | 61107-3959
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Country | US
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Telephone | 815-200-3612
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Fax |
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Provider Business Mailing Address
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Address Line | 124 N WATER ST STE 204E
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City | ROCKFORD
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State | IL
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Zip | 61107-3959
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Country | US
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Telephone | 815-200-3612
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. CHRISTOPHER WINTHROP SAHLI
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Credential | DC
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Telephone | 815-200-3612
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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 | 038.012505
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License Number State | IL
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