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Organization
CHIROPRACTIC SPECIALIST, INC.
Active
Organization
CHIROPRACTIC SPECIALIST, INC.
Active
Other names
Core Physicians Group LTD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN WADE VICKERY D.C. (PRESIDENT)
(618) 654-3000
Entity
Organization
Contact information
Practice address
1000 ZSCHOKKE ST, HIGHLAND, IL 62249-1650
(618) 654-3000
(618) 654-1567
Mailing address
PO BOX 142, HIGHLAND, IL 62249-0142
(618) 654-3000
(618) 654-1567
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/21/2010
Last updated
01/24/2017
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