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Individual

DR. JEFF LEE DAVIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1181 S STATE ROUTE 157, SUITE 200C, EDWARDSVILLE, IL 62025-3710
(618) 288-4100
(618) 307-3283
Mailing address
916 TALON DR, SUITE 102, O FALLON, IL 62269-1848
(618) 628-8211
(618) 628-0883

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011166
IL
111N00000X
Chiropractor
CE006572
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
900068033
ESSENCE
IL
Enumeration date
09/23/2005
Last updated
10/29/2009
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