Individual
DONALD R. SELVIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
608 BROADWAY AVE, MATTOON, IL 61938-4321
(217) 235-4664
(217) 235-2100
Mailing address
608 BROADWAY AVE, MATTOON, IL 61938-4321
(217) 235-4664
(217) 235-2100
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
10/26/2006
Last updated
11/20/2007
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