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Organization
PETRIE CHIROPRACTIC CLINIC
Active
Organization
PETRIE CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA J PETRIE D.C. (OWNER)
(815) 288-3614
Entity
Organization
Contact information
Practice address
315 S PEORIA AVE, DIXON, IL 61021-2956
(815) 288-3614
(815) 285-3525
Mailing address
315 S PEORIA AVE, DIXON, IL 61021-2956
(815) 288-3614
(815) 285-3525
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038004367
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038004367
—
IL
01
—
5282006
BLUE CROSS/ BLUE SHIELD
IL
Enumeration date
05/18/2006
Last updated
11/06/2007
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