Organization
KANKAKEE VALLEY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE WILLIAM RANDLES D.C. (CEO)
(815) 933-6624
Entity
Organization
Contact information
Practice address
300 NORTH KENNEDY DRIVE, SUITE 2, BRADLEY, IL 60915
(815) 933-6624
(815) 933-6664
Mailing address
300 NORTH KENNEDY DRIVE, SUITE 2, BRADLEY, IL 60915
(815) 933-6624
(815) 933-6664
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011709
IL
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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