Organization
INTEGRATED MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MICHAEL THAYER DC (OWNER)
(618) 692-6700
Entity
Organization
Contact information
Practice address
435 S BUCHANAN ST, SUITE B, EDWARDSVILLE, IL 62025-2091
(618) 692-6700
(618) 692-6711
Mailing address
PO BOX 997, EDWARDSVILLE, IL 62025-0997
(618) 692-6700
(618) 692-6711
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2006
Last updated
05/11/2009
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