Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038.010778 | IL |
N | 111NN1001X | Nutrition | 038.010778 | IL |
N | 111NP0017X | Pediatric Chiropractor | 038.010778 | IL |
NPI | 1215190020 |
---|---|
Provider Name | David M Atkins |
First Address | Jacksonville, IL 62650-3583 |
Second Address | Jacksonville, IL 62650-3583 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 02/07/2008 |