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Organization
ACUPUNCTURE & CHIROPRACTIC CENTER
Active
Organization
ACUPUNCTURE & CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS T DISTASIO D.C. L.AC. (OWNER)
(217) 544-8118
Entity
Organization
Contact information
Practice address
716 S 2ND ST, SPRINGFIELD, IL 62704-2516
(217) 544-8118
Mailing address
716 S 2ND ST, SPRINGFIELD, IL 62704-2516
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
038003935
IL
261QM1300X
Multi-Specialty Clinic/Center
198000025
IL
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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