Provider Demographics
NPI:1891054300
Name:KNOX COUNTY CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:KNOX COUNTY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SETCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-342-1612
Mailing Address - Street 1:2522 E LINCOLNWAY
Mailing Address - Street 2:SUITE G
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-3058
Mailing Address - Country:US
Mailing Address - Phone:815-626-6630
Mailing Address - Fax:815-626-6796
Practice Address - Street 1:2522 E LINCOLNWAY
Practice Address - Street 2:SUITE G
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-3058
Practice Address - Country:US
Practice Address - Phone:815-626-6630
Practice Address - Fax:815-626-6796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty