Organization
GRANITE CITY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL JASON MILLER DC (DOCTOR OF CHIROPRACTIC)
(618) 452-2300
Entity
Organization
Contact information
Practice address
3136 NAMEOKI RD, GRANITE CITY, IL 62040-5013
(618) 452-2300
(618) 452-0373
Mailing address
258 GEREMMA DR, BALLWIN, MO 63011-3334
(314) 283-8421
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06026803
BLUE CROSS & BLUE SHIELD
IL
Enumeration date
07/28/2006
Last updated
08/22/2020
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