Organization
FORMAN CLINIC OF CHIROPRACTIC REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC DEAN FORMAN D.C. (OWNER/CHIROPRACITC)
(815) 288-6683
Entity
Organization
Contact information
Practice address
404 N GALENA AVE, DIXON, IL 61021-2115
(815) 288-6683
(815) 288-4892
Mailing address
404 N GALENA AVE, DIXON, IL 61021-2115
(815) 288-6683
(815) 288-4892
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
06/19/2006
Last updated
08/22/2020
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