Organization Name: | PEORIA CHIROPRACTIC PC |
NPI Number: | 1457537508 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RYDER CHURCH (DOCTOR) |
Mailing Address: | 2015 W Glen Ave Suite 220 Peoria |
State: | IL US |
Postal Code: | 616144690 |
Phone Number: | 3096931212 |
Fax Number: | 3096932147 |
NPI Enumeration Date: | 01/18/2008 |
NPI Last Update Date: | 07/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 038007166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |