Organization
INTEGRATED MEDICAL GROUP, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MICHAEL THAYER DC (OWNER)
(618) 654-3900
Entity
Organization
Contact information
Practice address
435-B SOUTH BUCHANAN ST, EDWARDSVILLE, IL 62025-2091
(618) 692-6700
Mailing address
PO BOX 997, EDWARDSVILLE, IL 62025-0997
(618) 692-6700
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/02/2007
Last updated
11/13/2009
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