Organization
DEEP ROOTS CHIROPRACTIC & WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN PATRICK REIDER DC (DOCTOR OF CHIROPRACTIC)
(773) 570-6404
Entity
Organization
Contact information
Practice address
6178 N NORTHWEST HWY, CHICAGO, IL 60631-2126
(773) 570-6404
Mailing address
6178F N NORTHWEST HWY, CHICAGO, IL 60631-2126
(773) 570-6404
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
08/21/2023
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