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Organization
TCWC GLEN CARBON, LLC
Active
Organization
TCWC GLEN CARBON, LLC
Active
Other names
The Chiropractic Wellness Connection Glen Carbon
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINA T CLAYWELL DC (OWNER)
(618) 792-2762
Entity
Organization
Contact information
Practice address
11 GINGER CREEK VLG, GLEN CARBON, IL 62034-3517
(618) 307-9540
Mailing address
1901 CHEYENNE DR, GODFREY, IL 62035-1532
(618) 792-2762
(636) 978-7570
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038012948
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689066573
INDIVIDUAL NPI
MO
Enumeration date
04/08/2016
Last updated
09/12/2016
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