Progressive Spine & Joint Center LLC

NPI #1902117237 in O Fallon, Illinois

Provider Information

NPI Number: 1902117237
Entity Type: Organization
Organization Name: Progressive Spine & Joint Center LLC
Primary Specialty: Chiropractor
Enumeration Date: Jul 1, 2010
Last Updated: Feb 16, 2011

Practice Location

Address: 4965 STONE FALLS CTR
Address 2: SUITE 3
City: O Fallon
State: Illinois
ZIP Code: 62269-7803
Phone: (618) 622-0096

Authorized Official

Name: DR. JORDAN WADE VICKERY, D.C.
Title: CHIROPRACTOR/OWNER
Phone: (618) 622-0096

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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