Individual
DR. JONATHAN DAVID DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
607 W OAK ST, WEST FRANKFORT, IL 62896-2561
(618) 435-2500
Mailing address
805 N MAIN ST, BENTON, IL 62812-1019
(618) 435-2500
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
02/20/2008
Last updated
02/20/2008
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