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Organization
LIFESTYLE CHIROPRACTIC GROUP LLC
Active
Organization
LIFESTYLE CHIROPRACTIC GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM JEFFREY KOPPARI D.C. (OWNER/DOCTOR OF CHIROPRACTIC)
(815) 623-3379
Entity
Organization
Contact information
Practice address
5290 WILLIAMS DR, ROSCOE, IL 61073-9222
(815) 623-3379
(815) 623-3380
Mailing address
5290 WILLIAMS DR, P.O. BOX 888, ROSCOE, IL 61073-9222
(815) 623-3379
(815) 623-3380
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
NULL
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
06/03/2008
Last updated
03/21/2011
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