Midwest Spine & Sport Chiropractic

NPI #1336460385 in O Fallon, Illinois

Provider Information

NPI Number
1336460385
Entity Type
Organization
Organization Name
Midwest Spine & Sport Chiropractic
Primary Specialty
Chiropractor - Rehabilitation
Enumeration Date
Jun 14, 2010
Last Updated
Jun 14, 2010

Practice Location

Address
1210 PARAGON DR
Address 2
SUITE 1B
ZIP Code
62269-1773
Phone
(618) 973-5522

Authorized Official

Name
DR. KRISTI KAY DIECKMANN, D.C., M.S.
Title
OWNER
Phone
(618) 973-5522

Specialties & Taxonomy Codes

Specialty
Chiropractor - RehabilitationRehabilitation

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