Individual
DR. JUSTIN CHANEY TUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6808 N. KNOXVILLE AVE., SUITE B, PEORIA, IL 61614
(309) 693-9200
Mailing address
6808 N. KNOXVILLE AVE., SUITE B, PEORIA, IL 61614
(309) 693-9200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.010839
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7232203
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/24/2008
Last updated
06/24/2008
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