Organization
LEBANON CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE FISCHER DC (PRESIDENT)
(618) 537-4407
Entity
Organization
Contact information
Practice address
110 W SAINT LOUIS ST, LEBANON, IL 62254-1559
(618) 537-4407
Mailing address
110 W SAINT LOUIS ST, LEBANON, IL 62254-1559
(618) 537-4407
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
634840
MEDICARE
IL
Enumeration date
01/08/2007
Last updated
06/21/2018
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