Individual
DR. MICHAEL SCOTT LISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5003 N ILLINOIS ST, STE 2, FAIRVIEW HEIGHTS, IL 62208-3419
(618) 234-1455
Mailing address
5003 N ILLINOIS ST, STE 2, FAIRVIEW HEIGHTS, IL 62208-3419
(618) 234-1455
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011493
IL
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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