Organization
HARRISBURG FAMILY CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN KEITH THORPE DC (PRESIDENT CEO)
(618) 252-5300
Entity
Organization
Contact information
Practice address
1220 E SLOAN ST, HARRISBURG, IL 62946-2716
(618) 252-5300
Mailing address
1220 E SLOAN ST, HARRISBURG, IL 62946-2716
(618) 252-5300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-010493
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038010493
MEDICAID
IL
01
—
744343
HEALTHLINK
IL
01
—
8332029
BCBS OF IL
IL
01
—
P00314027
PIN
IL
Enumeration date
10/26/2006
Last updated
07/13/2007
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