Organization
CHIROPRACTIC SPECIALIST, INC.
Active
Other names
Core Physicians Group LTD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN WADE VICKERY D.C. (PRESIDENT)
(618) 654-3000
Entity
Organization
Contact information
Practice address
1000 ZSCHOKKE ST, HIGHLAND, IL 62249-1650
(618) 654-3000
(618) 654-1567
Mailing address
PO BOX 142, HIGHLAND, IL 62249-0142
(618) 654-3000
(618) 654-1567
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/21/2010
Last updated
01/24/2017
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