Organization
BACK TO BASICS CHIROPRACTIC HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER NOELLE MANTEY-VANLOOCKE D.C. (OWNER/MANAGER)
(847) 475-4960
Entity
Organization
Contact information
Practice address
1318 CHICAGO AVE, EVANSTON, IL 60201-4725
(847) 475-4960
(847) 475-4966
Mailing address
1318 CHICAGO AVE, EVANSTON, IL 60201-4725
(847) 475-4960
(847) 475-4966
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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