Individual
DR. MICHAEL WAYNE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
217 E BROADWAY BLVD, JOHNSTON CITY, IL 62951-1604
(618) 983-3900
(618) 983-3900
Mailing address
217 E BROADWAY BLVD, JOHNSTON CITY, IL 62951-1604
(618) 983-3900
(618) 983-3900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011140
IL
111N00000X
Chiropractor
2007030809
MO
Other
Enumeration date
10/11/2007
Last updated
01/20/2009
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