Organization
VILLAGE CHIROPRACTIC
Active
Other names
BACK IN SHAPE CHIROPRACTIC AND WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH B POTETTI D.C. (OWNER)
(815) 398-3334
Entity
Organization
Contact information
Practice address
1639 N ALPINE RD, 503, ROCKFORD, IL 61107-1449
(815) 398-3334
(815) 398-3469
Mailing address
1639 N ALPINE RD, 503, ROCKFORD, IL 61107-1449
(815) 398-3334
(815) 398-3469
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
IL
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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