| Modern Movement Pllc | |
|
1815 S Main St, Eureka, IL 61530-1707 | |
| (309) 265-0200 | |
| (309) 205-3896 |
| Full Name | Modern Movement Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1815 S Main St, Eureka, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275366510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Keith William Walder |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659102382 PECOS PAC ID: 8628519139 Enrollment ID: I20240925000039 |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Movement Pllc 1815 S Main St, Eureka, IL 61530-1707 Ph: (309) 265-0200 | Modern Movement Pllc 1815 S Main St, Eureka, IL 61530-1707 Ph: (309) 265-0200 |
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Keith William Walder, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1815 S Main St, Eureka, IL 61530 Phone: 309-265-0200 Fax: 309-205-3896 |