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Individual

CRAIG M BRETZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
101 W JEFFERSON ST, SUITE A, SULLIVAN, IL 61951-1914
(217) 728-8891
(217) 728-8891
Mailing address
101 W JEFFERSON ST, SUITE A, SULLIVAN, IL 61951-1914
(217) 728-8891
(217) 728-8891

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7008408
BLUE CROSS & BLUE SHIELD
IL
Enumeration date
09/22/2006
Last updated
07/09/2007
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