Individual
BENJAMIN CHARLES DEIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
7800 N SOMMER ST STE 203, PEORIA, IL 61615-1990
(309) 691-9767
Mailing address
316 E EDGEWOOD ST, MORTON, IL 61550-2534
(309) 369-5474
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.013464
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
09/09/2019
Last updated
11/05/2019
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