SOUTHERN ILLINOIS SPORT AND SPINE LLC

BENTON, IL
NPI1215277967
Entity TypeOrganization
Authorized ContactLUKE WILLIAM KOEHN
Chiropractor
618-521-0552
Organization Subpart ?No
Primary Taxonomy111N00000X Chiropractor
(Licence: IL  038012350)
Enumeration Date2013-02-17
Last Update Date2013-05-07
Business Address
SOUTHERN ILLINOIS SPORT AND SPINE LLC
106 W WASHINGTON ST
BENTON, IL 62812-1337
Phone number: 618-435-3888
Mailing Address
SOUTHERN ILLINOIS SPORT AND SPINE LLC
106 W WASHINGTON ST
BENTON, IL 62812-1337
Phone number: 618-435-3888