Individual
J CASEY PRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1003 BARCLAY CT, CHAMPAIGN, IL 61821-7019
(217) 898-7773
Mailing address
1003 BARCLAY CT, CHAMPAIGN, IL 61821-7019
(217) 898-7773
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.012979
IL
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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