Organization
MAIN HEALTHCARE S C
Active
Other names
The Main Spinal Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER ROBERT MAIN D.C. (PRESIDENT)
(309) 662-1000
Entity
Organization
Contact information
Practice address
2412 E WASHINGTON ST, SUITE 6A, BLOOMINGTON, IL 61704-4497
(309) 622-1000
(309) 663-0686
Mailing address
2412 E WASHINGTON ST, SUITE 6A, BLOOMINGTON, IL 61704-4497
(309) 622-1000
(309) 663-0686
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038-008776
IL
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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