Individual provider · Type 1 NPI
Michael Wayne Childress, DC
Chiropractor · Johnston City, IL
NPI number
1518155886
Active
Practice location
217 E Broadway Blvd
Johnston City, IL 62951-1604
Fax (618) 983-3900
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 038011140 (IL) |
| Chiropractor | 111N00000X | 2007030809 (MO) |
Chiropractor: 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.
Another provider at this address
About NPI 1518155886
Michael Wayne Childress, DC's National Provider Identifier is 1518155886, issued on Oct 11, 2007. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Johnston City, IL. The record was last updated on Jan 20, 2009.