Provider Demographics
NPI:1962011825
Name:KRISTIN E WHITE CHIROPRACTIC CARE INC
Entity Type:Organization
Organization Name:KRISTIN E WHITE CHIROPRACTIC CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-877-2522
Mailing Address - Street 1:4607 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-9268
Mailing Address - Country:US
Mailing Address - Phone:217-775-3931
Mailing Address - Fax:
Practice Address - Street 1:3350 N WATER ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-2353
Practice Address - Country:US
Practice Address - Phone:217-877-2522
Practice Address - Fax:217-877-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty