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1790128387
DANE JACK CHURCH
SPRINGFIELD, IL
NPI
1790128387
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery
(Licence: IL 036148467)
Enumeration Date
2013-04-12
Last Update Date
2020-04-13
Business Address
DANE JACK CHURCH MD
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711-9252
Phone number: 217-547-9100
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Mailing Address
DANE JACK CHURCH MD
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711-9252
Phone number: 217-547-9100
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