Individual
DR. JERRY B WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
611 MARGARET ST, PEKIN, IL 61554-3355
(309) 346-9778
Mailing address
611 MARGARET ST, PEKIN, IL 61554-3355
(309) 346-9778
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009082006
BLUE CROSS BLUE SHIELD
IL
01
—
35008704CL20501
PALMETTO GBA RR MEDICARE
—
Enumeration date
07/24/2006
Last updated
07/08/2007
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