Provider Demographics
NPI:1144589664
Name:INTEGRITY CHIROPRACTIC AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:INTEGRITY CHIROPRACTIC AND REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:618-624-4242
Mailing Address - Street 1:705 W US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1900
Mailing Address - Country:US
Mailing Address - Phone:618-624-4242
Mailing Address - Fax:618-624-5127
Practice Address - Street 1:705 W US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1900
Practice Address - Country:US
Practice Address - Phone:618-624-4242
Practice Address - Fax:618-624-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty