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Organization
THE WELLNESS SOURCE OF TEDDIE KOSSOF, INC
Active
Organization
THE WELLNESS SOURCE OF TEDDIE KOSSOF, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS J LOPEZ DC (OWNER)
(312) 848-5668
Entity
Organization
Contact information
Practice address
3324 N HALSTED ST, CHICAGO, IL 60657-2413
(312) 848-5668
Mailing address
3324 N HALSTED ST, CHICAGO, IL 60657-2413
(773) 906-9265
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038010594
IL
Other
Enumeration date
03/24/2014
Last updated
01/27/2016
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