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Organization
ICAN CLINIC LLC
Active
Organization
ICAN CLINIC LLC
Active
Other names
Wood River Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S HARBISON DC (OWNER/DIRECTOR)
(618) 254-2273
Entity
Organization
Contact information
Practice address
441 S STATE ROUTE 157 STE 102, EDWARDSVILLE, IL 62025-4017
(618) 254-2273
(618) 254-8476
Mailing address
441 S STATE ROUTE 157 STE 102, EDWARDSVILLE, IL 62025-4017
(618) 254-2273
(618) 254-8476
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038.12178
IL
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/14/2012
Last updated
08/03/2022
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