# PROACTIVE CHIROPRACTIC & LASER CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922633395
- **Authorized official:** DR. RYAN KURT FRIEL DC (OWNER, CHIROPRACTOR)
- **Authorized official phone:** (815) 757-5463

## Contact information

- **Practice address:** 2535 BETHANY RD STE 100, SYCAMORE, IL 60178-3126
- **Practice address phone:** (815) 517-0826
- **Mailing address:** 2535 BETHANY RD STE 100, SYCAMORE, IL 60178-3126
- **Mailing address phone:** (815) 517-0826

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 03/06/2020
- **Last updated:** 03/06/2020