Provider Demographics
NPI:1417100215
Name:WEBER CHIROPRACTIC CENTERS LLC
Entity Type:Organization
Organization Name:WEBER CHIROPRACTIC CENTERS LLC
Other - Org Name:COLLINSVILLE CHIROPRACTIC HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-344-0071
Mailing Address - Street 1:1600 VANDALIA ST
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-4459
Mailing Address - Country:US
Mailing Address - Phone:618-344-0071
Mailing Address - Fax:618-344-0095
Practice Address - Street 1:1600 VANDALIA ST
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-4459
Practice Address - Country:US
Practice Address - Phone:618-344-0071
Practice Address - Fax:618-344-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty