| Performance Chiropractic And Sports Rehab | |
|
104 N Grant St Olney IL 62450-2612 | |
| (618) 395-7246 | |
| (618) 395-7249 |
| Full Name | Performance Chiropractic And Sports Rehab |
|---|---|
| Speciality | Clinic/center |
| Location | 104 N Grant St, Olney, Illinois |
| Authorized Official Name and Position | Derek Alan Leist (PRESIDENT) |
| Authorized Official Contact | 3149541885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Performance Chiropractic And Sports Rehab 104 N Grant St Olney IL 62450-2612 Ph: (618) 395-7246 | Performance Chiropractic And Sports Rehab 104 N Grant St Olney IL 62450-2612 Ph: (618) 395-7246 |
| NPI Number | 1710239264 |
|---|---|
| Provider Enumeration Date | 10/09/2012 |
| Last Update Date | 10/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710239264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | IL038012269 (Illinois) | Primary |
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Carle Rmh Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 605 E Main St, Olney, IL 62450 Phone: 618-392-1140 | |
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