PEORIA SPINE AND SPORT LTD. NPI 1134764517

NPI Information

PEORIA SPINE AND SPORT LTD. is a chiropractor in Peoria, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. PEORIA SPINE AND SPORT LTD. NPI is 1134764517. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7800 N SOMMER ST STE 203
PEORIA, IL
ZIP 61615-990
Phone: (309) 691-9767

The provider's authorized official is Benjamin Charles Deig .
The authorized official title is President and has the following contact phone number (309) 691-9767.

The enumeration date for this NPI number is 11/9/2019 and was last updated on 11/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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