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Organization

EDWARDSVILLE PHYSICIANS GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL HARBISON DC (PRESIDENT/OWNER)
(618) 254-2273
Entity
Organization

Contact information

Practice address
441 SOUTH STATE ROUTE 157 SUITE 102, EDWARDSVILLE, IL 62025-4012
(618) 254-2273
(618) 254-8476
Mailing address
441 SOUTH STATE ROUTE 157 SUITE 102, EDWARDSVILLE, IL 62025-4012
(618) 254-2273
(618) 254-8476

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
12/06/2018
Last updated
12/06/2018
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