Organization
RECOVERUSCENTERS-CARBONDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILTON THEODORE MORTER III DC (OWNER)
(479) 619-9320
Entity
Organization
Contact information
Practice address
2250 REED STATION PKWY STE 204, CARBONDALE, IL 62901-8104
(618) 519-9445
Mailing address
2250 REED STATION PKWY STE 204, CARBONDALE, IL 62901-8104
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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