Organization
MANCE CHIROPRACTIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD LEE MANCE DC (PRESIDENT)
(815) 772-7641
Entity
Organization
Contact information
Practice address
125 EAST MAIN STREET, MORRISON, IL 61270-2639
(815) 772-7641
(815) 772-7642
Mailing address
125 EAST MAIN STREET, MORRISON, IL 61270-2639
(815) 772-7641
(815) 772-7642
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720265572
NPI
—
05
—
612270
—
IL
01
—
9882009
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/30/2006
Last updated
02/05/2008
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