Organization
ICAN CLINIC MO PC
Active
Other names
ICAN CLINIC MO PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL HARBISON DC (OWNER)
(618) 254-2273
Entity
Organization
Contact information
Practice address
106 FOUR SEASONS SHOPPING CTR STE 110, CHESTERFIELD, MO 63017-3173
(618) 254-2273
Mailing address
106 FOUR SEASONS SHOPPING CTR STE 110, CHESTERFIELD, MO 63017-3173
(618) 254-2273
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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