Organization
SG CHIROPRACTIC PC
Active
Other names
Advanced Body Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG LILLIS (BUSINESS MANAGER)
(507) 533-4777
Entity
Organization
Contact information
Practice address
93 20TH ST NE, STEWARTVILLE, MN 55976-8421
(507) 533-4777
(507) 533-4778
Mailing address
93 20TH ST NE, STEWARTVILLE, MN 55976-8421
(507) 533-4777
(507) 533-4778
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4424
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3366567
—
MN
Enumeration date
03/13/2014
Last updated
03/13/2014
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