Organization
CHIROPRACTIC & SPINAL CARE CLINIC OF MASCOUTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON JAY BOLLENBAUGH D.C. (PRESENDENT / OWNER)
(618) 566-3500
Entity
Organization
Contact information
Practice address
111 E CHURCH ST, MASCOUTAH, IL 62258-2110
(618) 566-3500
(618) 566-3500
Mailing address
13166 PRAIRIE GRASS LN, BREESE, IL 62230-4328
(618) 420-0409
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
IL
Other
Enumeration date
05/09/2006
Last updated
08/22/2020
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