Individual
DR. JORDAN WADE VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12860 TROXLER AVE, HIGHLAND, IL 62249-2898
(618) 654-3000
Mailing address
1000 ZSCHOKKE ST, HIGHLAND, IL 62249-1650
(618) 654-4451
(618) 654-1567
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011632
IL
Other
Enumeration date
03/02/2010
Last updated
12/14/2015
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