Individual
DR. MILTON THEODORE MORTER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2250 REED STATION PKWY STE 204, CARBONDALE, IL 62901-8104
(618) 519-9445
Mailing address
215 W POPLAR ST, ROGERS, AR 72756-4556
(479) 631-2749
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038.013346
IL
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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