Provider Demographics
NPI: | 1033357207 |
---|---|
Name: | HEALTH FROM WITHIN CHIROPRACTIC WELLNESS CENTER OF MOLINE, SC |
Entity Type: | Organization |
Organization Name: | HEALTH FROM WITHIN CHIROPRACTIC WELLNESS CENTER OF MOLINE, SC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ASHLY |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | OCHSNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 708-349-0040 |
Mailing Address - Street 1: | 9654 W 131ST ST |
Mailing Address - Street 2: | #311 |
Mailing Address - City: | PALOS PARK |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60464-1640 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 708-349-0040 |
Mailing Address - Fax: | 708-349-0060 |
Practice Address - Street 1: | 1909 52ND AVE |
Practice Address - Street 2: | |
Practice Address - City: | MOLINE |
Practice Address - State: | IL |
Practice Address - Zip Code: | 61265-6381 |
Practice Address - Country: | US |
Practice Address - Phone: | 708-349-0040 |
Practice Address - Fax: | 708-349-0060 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-01-27 |
Last Update Date: | 2009-08-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |