Provider Demographics
NPI:1528496163
Name:COMPLETE CHIROPRACTIC ACUPUNCTURE AND FAMILY WELLNESS LLC
Entity type:Organization
Organization Name:COMPLETE CHIROPRACTIC ACUPUNCTURE AND FAMILY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HOWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-473-6832
Mailing Address - Street 1:114 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62363-1427
Mailing Address - Country:US
Mailing Address - Phone:217-285-1915
Mailing Address - Fax:
Practice Address - Street 1:114 N MONROE ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:IL
Practice Address - Zip Code:62363-1427
Practice Address - Country:US
Practice Address - Phone:217-285-1915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPLETE CHIROPRACTIC ACUPUNCTURE AND FAMILY WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-17
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012519111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty