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Organization

ANDINO CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT ANDINO DC (OWNER)
(815) 397-7889
Entity
Organization

Contact information

Practice address
2846 LANGSTONE DR, ROCKFORD, IL 61109-1771
(815) 397-7889
Mailing address
2846 LANGSTONE DR, ROCKFORD, IL 61109-1771
(815) 397-7889

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009900
IL
111NP0017X
Pediatric Chiropractor
038010991
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11540208
CAQH
Enumeration date
02/19/2009
Last updated
02/19/2009
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