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Organization
ACCIDENT & SPORTS CLINIC SC
Active
Organization
ACCIDENT & SPORTS CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARRIE FITTON D.C. (OWNER)
(309) 664-6040
Entity
Organization
Contact information
Practice address
3901 GENERAL ELECTRIC RD, #2, BLOOMINGTON, IL 61704-8746
(309) 664-6040
(309) 664-6121
Mailing address
3901 GENERAL ELECTRIC RD, #2, BLOOMINGTON, IL 61704-8746
(309) 664-6040
(309) 664-6121
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005782025
BLUE CROSS/BLUE SHIELD
IL
05
—
038005760
—
IL
01
—
350036554
RAILROAD MEDICARE
IL
Enumeration date
08/05/2006
Last updated
06/09/2008
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