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Organization

ADVANCED BODY CHIROPRACTIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHANIE C LILLIS DC (CHIROPRACTOR/OWNER)
(507) 533-4777
Entity
Organization

Contact information

Practice address
93 20TH ST NE, STEWARTVILLE, MN 55976-8421
(507) 533-4777
(507) 533-4778
Mailing address
93 20TH ST NE, STEWARTVILLE, MN 55976-8421
(507) 533-4777
(507) 533-4778

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
091K3AD
BLUE CROSS BLUE SHIELD
MN
05
894642600
MN
Enumeration date
09/16/2006
Last updated
11/19/2013
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