Individual
DR. JACOB FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2 TERMINAL DR, SUITE 15, EAST ALTON, IL 62024-2268
(618) 258-8610
Mailing address
110 N ELM ST, BETHALTO, IL 62010-2266
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011766
IL
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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