Individual
DR. JOHN LAURENCE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
203 NORTH GRAND AVE WEST, SPRINGFIELD, IL 62702-2550
(217) 522-6500
(217) 753-3465
Mailing address
203 NORTH GRAND AVE WEST, SPRINGFIELD, IL 62702-2550
(217) 522-6500
(217) 753-3465
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038006597
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08482049
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/19/2006
Last updated
06/03/2013
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