Spine And Sport Center | |
205 N Grand Ave W, Springfield, IL 62702-2550 | |
(217) 525-2035 | |
Not Available |
Full Name | Spine And Sport Center |
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Type | Facility |
Speciality | Chiropractor |
Location | 205 N Grand Ave W, Springfield, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801263256 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 038012871 (Illinois) | Primary |
Provider Name | Casey Steven Sitko |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1114394640 PECOS PAC ID: 6800103656 Enrollment ID: I20150911000827 |
Mailing Address | Practice Location Address |
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Spine And Sport Center 205 N Grand Ave W, Springfield, IL 62702-2550 Ph: (217) 525-2035 | Spine And Sport Center 205 N Grand Ave W, Springfield, IL 62702-2550 Ph: (217) 525-2035 |
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