Organization
JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES A BRIGGS D.C. (OWNER)
(618) 259-3321
Entity
Organization
Contact information
Practice address
1702 VAUGHN RD, WOOD RIVER, IL 62095
(618) 259-3321
(618) 259-3324
Mailing address
P.O. BOX 649, WOOD RIVER, IL 62095
(618) 259-3321
(618) 259-3324
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
042-618378
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5933000001
MEDICARE DME
IL
Enumeration date
05/03/2006
Last updated
01/22/2014
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