Organization
SPORTCHIRO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC DOUGLAS DIXON DC (OWNER/OPERATOR)
(618) 791-2983
Entity
Organization
Contact information
Practice address
1120 S STATE ROUTE 157, STE. 100, EDWARDSVILLE, IL 62025-3786
(618) 791-2983
Mailing address
1120 S STATE ROUTE 157, STE. 100, EDWARDSVILLE, IL 62025-3786
(618) 791-2983
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
038012183
IL
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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