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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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