Provider Demographics
NPI:1710442488
Name:VBL HOLDINGS, LTD.
Entity Type:Organization
Organization Name:VBL HOLDINGS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:LYELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-658-9995
Mailing Address - Street 1:117 W POINT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-9590
Mailing Address - Country:US
Mailing Address - Phone:209-658-9995
Mailing Address - Fax:844-892-4533
Practice Address - Street 1:1521 W WALNUT ST STE D
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-1153
Practice Address - Country:US
Practice Address - Phone:217-243-4333
Practice Address - Fax:844-892-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty