Organization
FREEPORT FAMILY CHIROPRACTIC & ACUPUNCTURE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE LEIGH SDAO DC (DOCTOR OF CHIROPRACTIC)
(815) 232-4217
Entity
Organization
Contact information
Practice address
455 W STEPHENSON ST, FREEPORT, IL 61032-5001
(815) 232-4217
(815) 233-3379
Mailing address
455 W STEPHENSON ST, FREEPORT, IL 61032-5001
(815) 232-4217
(815) 233-3379
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-008743
IL
111N00000X
Chiropractor
Primary
038-009058
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210593
MEDICARE P10 NUMBER
IL
Enumeration date
12/28/2006
Last updated
12/18/2012
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