Provider Demographics
NPI:1740807932
Name:MOHR CHIROPRACTIC
Entity type:Organization
Organization Name:MOHR CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-551-6440
Mailing Address - Street 1:20 N CANNONBALL TRL
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:IL
Mailing Address - Zip Code:60512-9770
Mailing Address - Country:US
Mailing Address - Phone:630-551-6440
Mailing Address - Fax:
Practice Address - Street 1:20 N CANNONBALL TRL
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:IL
Practice Address - Zip Code:60512-9770
Practice Address - Country:US
Practice Address - Phone:630-551-6440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty