Individual
JOHN GIRADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
205 E MAIN ST, CARBONDALE, IL 62901-3008
(618) 457-0459
(618) 549-9203
Mailing address
205 E MAIN ST, CARBONDALE, IL 62901-3008
(618) 457-0459
(618) 549-9203
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038006734
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038006734
IL LICENSE
IL
01
—
371267591
TAX ID
IL
Enumeration date
01/18/2007
Last updated
07/23/2010
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