Individual
DR. MARK EAVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3986 MARYVILLE RD, GRANITE CITY, IL 62040-4191
(618) 797-0618
(618) 797-2243
Mailing address
3986 MARYVILLE RD, GRANITE CITY, IL 62040-4191
(618) 797-0618
(618) 797-2243
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
03/20/2006
Last updated
07/19/2007
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