Provider Demographics
NPI:1548724883
Name:HARPER BACK PAIN CLINIC
Entity type:Organization
Organization Name:HARPER BACK PAIN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-740-1750
Mailing Address - Street 1:821 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62881-1408
Mailing Address - Country:US
Mailing Address - Phone:618-740-1750
Mailing Address - Fax:618-740-1250
Practice Address - Street 1:821 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IL
Practice Address - Zip Code:62881-1408
Practice Address - Country:US
Practice Address - Phone:618-740-1750
Practice Address - Fax:618-740-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty