| Dr Jeremy R Clark, DC | |
|
100 N Kennedy Blvd, Vandalia, IL 62471-2314 | |
| (618) 531-1141 | |
| Not Available |
| Full Name | Dr Jeremy R Clark |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 100 N Kennedy Blvd, Vandalia, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710018395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | IL038-009768 (Illinois) | Primary |
| Provider Name | Pain Relief Center Of Vandalia Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1588773089 PECOS PAC ID: 6507894995 Enrollment ID: O20050727000778 |
| Provider Name | Integrative Performance Medical Group, Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1699232637 PECOS PAC ID: 9436548542 Enrollment ID: O20211111000607 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeremy R Clark, DC 100 N Kennedy Blvd, Vandalia, IL 62471-2314 Ph: (618) 531-1141 | Dr Jeremy R Clark, DC 100 N Kennedy Blvd, Vandalia, IL 62471-2314 Ph: (618) 531-1141 |
Jedidiah Cox, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 825 New York Dr Ste 1, Vandalia, IL 62471 Phone: 618-283-2230 Fax: 618-283-1868 | |
J Cox Enterprises Ltd Chiropractor Medicare: Medicare Enrolled Practice Location: 825 New York Dr Ste 1, Vandalia, IL 62471 Phone: 618-283-2230 Fax: 618-283-1868 | |
Tepperberg Chiropractic Center Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 110 S 6th St, Vandalia, IL 62471 Phone: 618-283-7070 Fax: 618-283-7049 | |
Pain Relief Center Of Vandalia Inc Chiropractor Medicare: Medicare Enrolled Practice Location: 100 N Kennedy Blvd, Vandalia, IL 62471 Phone: 618-283-1100 Fax: 618-283-1101 | |
Mr. Matthew Earl Labertew, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 825 New York Dr Ste 1, Vandalia, IL 62471 Phone: 618-283-2230 Fax: 618-283-1868 | |
Dr. Joseph J Solan, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 427 W Orchard St, Ste B, Vandalia, IL 62471 Phone: 618-283-0029 Fax: 618-283-4675 |