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Organization
TALLEY CHIROPRACTIC, PC
Active
Organization
TALLEY CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON R. TALLEY DC (PRESIDENT)
(618) 931-4000
Entity
Organization
Contact information
Practice address
3100 MARYVILLE RD, GRANITE CITY, IL 62040-5119
(618) 931-4000
(618) 931-4040
Mailing address
3100 MARYVILLE RD, GRANITE CITY, IL 62040-5119
(618) 931-4000
(618) 931-4040
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6026195
BCBS
IL
Enumeration date
03/24/2008
Last updated
03/24/2008
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