Organization
CREO-FIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY WAKEFIELD GASTON DC (OWNER)
(309) 370-7427
Entity
Organization
Contact information
Practice address
12127 W FARMINGTON RD, HANNA CITY, IL 61536-9481
(309) 370-7427
Mailing address
12127 W FARMINGTON RD, HANNA CITY, IL 61536-9481
(309) 370-7427
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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