Organization
DURHAM CHIROPRACTIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GRANT DURHAM (PRESIDENT)
(217) 623-4505
Entity
Organization
Contact information
Practice address
2175 ROUTE 29 NORTH, EDINBURG, IL 62531
(217) 623-4505
Mailing address
PO BOX 303, EDINBURG, IL 62531-0303
(217) 623-4505
(217) 623-4506
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-010457
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-0-A1-5058-0
BCBS
MI
Enumeration date
11/13/2006
Last updated
08/18/2011
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