Provider Demographics
NPI:1518205855
Name:WALK CHIROPRACTIC AND ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:WALK CHIROPRACTIC AND ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-460-0773
Mailing Address - Street 1:1501 E OAK ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-3778
Mailing Address - Country:US
Mailing Address - Phone:217-586-2000
Mailing Address - Fax:866-586-3420
Practice Address - Street 1:1501 E OAK ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-3778
Practice Address - Country:US
Practice Address - Phone:217-586-2000
Practice Address - Fax:866-586-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty