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Organization
GRANITE CITY CHIROPRACTIC LLC
Active
Organization
GRANITE CITY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL JASON MILLER DC (DOCTOR OF CHIROPRACTIC)
(618) 452-2300
Entity
Organization
Contact information
Practice address
3136 NAMEOKI RD, GRANITE CITY, IL 62040-5013
(618) 452-2300
(618) 452-0373
Mailing address
258 GEREMMA DR, BALLWIN, MO 63011-3334
(314) 283-8421
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06026803
BLUE CROSS & BLUE SHIELD
IL
Enumeration date
07/28/2006
Last updated
08/22/2020
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