Individual
DR. LAURIE ROBERT MESTDAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1550 N MAIN ST, COLUMBIA, IL 62236-1070
(618) 281-6167
(618) 281-4444
Mailing address
1550 N MAIN ST, COLUMBIA, IL 62236-1070
(618) 281-6167
(618) 281-4444
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009443
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038009443
—
IL
Enumeration date
01/08/2007
Last updated
07/12/2012
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