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Organization

PETERSBURG SPINE & SPORT INC

Active
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Organization

PETERSBURG SPINE & SPORT INC

Active
Other names
Petersburg Spine & Sport
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL GENSLER DC (CHIROPRACTOR)
(217) 632-7599
Entity
Organization

Contact information

Practice address
115 E DOUGLAS AVE, PETERSBURG, IL 62675-1558
(217) 632-7599
Mailing address
115 E DOUGLAS AVE, PETERSBURG, IL 62675-1558
(217) 632-7599

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011323
IL

Other

Enumeration date
02/06/2009
Last updated
01/05/2015
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