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Contact Information

PAIN RELIEF CENTER OF VANDALIA INC
100 N KENNEDY BLVD
VANDALIA, IL62471
 Phone: 618-283-1100
 Fax: 618-283-1101
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for PAIN RELIEF CENTER OF VANDALIA INC

NPI # 1588773089
LBN Legal business name PAIN RELIEF CENTER OF VANDALIA INC
Authorized official JEREMY CLARK - (DOCTOR OF CHIROPRACTIC)
Entity Organization
Organization subpart 1 No
Enumeration date 08/29/2006
Last updated 06/19/2015 - About 11 years ago
Identifiers
IL License # 038009768
IL Other 02632010 BCBS
IL Other 539980 HL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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