Southern Illinois Spine & Joint Center, LLC

NPI #1013098854 in Sparta, Illinois

Provider Information

NPI Number: 1013098854
Entity Type: Organization
Organization Name: Southern Illinois Spine & Joint Center, LLC
Primary Specialty: Chiropractor
Enumeration Date: Oct 18, 2006
Last Updated: Aug 17, 2010

Practice Location

Address: 202 W JACKSON ST
Address 2: SUITE A
City: Sparta
State: Illinois
ZIP Code: 62286-1676
Phone: (618) 443-2026

Authorized Official

Name: DR. RYAN ROBERT REISS, D.C.
Title: CHIROPRACTOR
Phone: (618) 443-2026

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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