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Individual

DR. BRIAN SCOTT WALSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
18209 EULA MAE PKWY, CARLYLE, IL 62231-6407
(618) 594-3671
(618) 594-3671
Mailing address
2800 NORTH CENTER ST., P.O. BOX 550, MARYVILLE, IL 62062
(618) 288-5044
(618) 288-9472

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009070
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06027786
BLUE CROSS BLUE SHIELD
IL
01
449206
HEALTHLINK
IL
Enumeration date
08/01/2006
Last updated
07/17/2013
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