Individual
DR. MICHAEL JOHN HERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1914 16TH ST, MOLINE, IL 61265-3953
(309) 762-1002
(309) 736-3484
Mailing address
1914 16TH ST, MOLINE, IL 61265-3953
(309) 762-1002
(309) 736-3484
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038010214
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038010214
—
IL
05
—
0590992
—
IA
01
—
K52432
MEDICARE PTAN
—
Enumeration date
10/01/2005
Last updated
03/13/2015
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