Provider First Line Business Practice Location Address:
1000 W WASHINGTON BLVD
Provider Second Line Business Practice Location Address:
WEST LOOP CHIROPRACTIC
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60607-2118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-850-2225
Provider Business Practice Location Address Fax Number:
312-850-2226
Provider Enumeration Date:
12/15/2005