| |
326 6th Ave West, Suite 1, Andalusia, IL 61232-0555 | |
(309) 798-5555 | |
(309) 798-5205 |
Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 326 6th Ave West, Andalusia, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861675217 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 038-010216 (Illinois) | Secondary |
111N00000X | Chiropractor | 060-009615 (Illinois) | Primary |
Mailing Address | Practice Location Address |
---|---|
326 6th Ave West Suite 1, Po Box 555, Andalusia, IL 61232-0555 Ph: (309) 798-5555 | 326 6th Ave West, Suite 1, Andalusia, IL 61232-0555 Ph: (309) 798-5555 |