Childress, Michael Wayne
Childress, Michael Wayne is an individual health care provider with primary practice located at 217 E Broadway Blvd , Johnston City IL 62951-1604. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Childress, Michael Wayne can be contacted via phone (618) 983-3900.Contact Information
Primary practice address
217 E Broadway Blvd
Johnston City IL 62951-1604
Phone: (618) 983-3900
Fax: (618) 983-3900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 038011140 | Illinois |
| Chiropractic Providers / Chiropractor | 111N00000X | 2007030809 | Missouri |
Profile Details
| NPI number | 1518155886 |
|---|---|
| LBN Legal business name | Childress, Michael Wayne |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2007 |
| Last updated | Jan 20th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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