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Organization
OPTIMUM WELLNESS AND REHABILITATION PC
Active
Organization
OPTIMUM WELLNESS AND REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD C COY DC (PRESIDENT)
(618) 288-3610
Entity
Organization
Contact information
Practice address
3407 S STATE ROUTE 157, GLEN CARBON, IL 62034-1042
(618) 288-3610
Mailing address
3407 S STATE ROUTE 157, GLEN CARBON, IL 62034-1042
(618) 288-3610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.005639
IL
225100000X
Physical Therapist
070-006607
IL
Other
Enumeration date
01/08/2007
Last updated
06/21/2018
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