| Complete Spine And Performance Llc | |
|
521 Belt Line Rd Collinsville IL 62234-4411 | |
| (618) 855-9130 | |
| (618) 855-9111 |
| Full Name | Complete Spine And Performance Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 521 Belt Line Rd, Collinsville, Illinois |
| Authorized Official Name and Position | Blake Reed (OWNER/CHIROPRACTOR) |
| Authorized Official Contact | 6188559130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Spine And Performance Llc 240 Sandridge Dr Collinsville IL 62234-3792 Ph: (618) 977-7317 | Complete Spine And Performance Llc 521 Belt Line Rd Collinsville IL 62234-4411 Ph: (618) 855-9130 |
| NPI Number | 1417732009 |
|---|---|
| Provider Enumeration Date | 08/30/2023 |
| Last Update Date | 08/30/2023 |
| Medicare PECOS PAC ID | 9436504552 |
|---|---|
| Medicare Enrollment ID | O20231010002508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417732009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Blake A Reed |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770156937 PECOS PAC ID: 9739587338 Enrollment ID: I20211013000011 |
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