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Organization
PROGRESSIVE SPINE & JOINT CENTER LLC
Active
Organization
PROGRESSIVE SPINE & JOINT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN WADE VICKERY D.C. (CHIROPRACTOR/OWNER)
(618) 622-0096
Entity
Organization
Contact information
Practice address
4965 STONE FALLS CTR, SUITE 3, O FALLON, IL 62269-7803
(618) 622-0096
(618) 624-9386
Mailing address
4965 STONE FALLS CTR, SUITE 3, O FALLON, IL 62269-7803
(618) 622-0096
(618) 624-9386
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011632
IL
Other
Enumeration date
07/01/2010
Last updated
02/16/2011
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