Organization
EASTLAND LIFESTYLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA BRUIN D.C. (OWNER)
(309) 662-8418
Entity
Organization
Contact information
Practice address
2710 E LINCOLN ST, BLOOMINGTON, IL 61704-6010
(309) 662-8418
(309) 662-8197
Mailing address
2710 E LINCOLN ST, BLOOMINGTON, IL 61704-6010
(309) 662-8418
(309) 662-8197
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/03/2016
Last updated
08/27/2019
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