Organization
TAYLORVILLE LIFELONG CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD JAMES PICONE D.C. (OWNERCHIROPRACTOR)
(217) 287-1040
Entity
Organization
Contact information
Practice address
400 W MARKET ST, TAYLORVILLE, IL 62568-2188
(217) 287-1040
Mailing address
400 W MARKET ST, TAYLORVILLE, IL 62568-2188
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
038010164
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01132002
BLUE CROSS BLUE SHIELD OF
IL
Enumeration date
07/20/2007
Last updated
07/20/2007
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