Provider First Line Business Practice Location Address:
REVIVE CHIROPRACTIC HEALING CENTER
Provider Second Line Business Practice Location Address:
1169 W MADISON ST
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-491-8100
Provider Business Practice Location Address Fax Number:
312-491-8501
Provider Enumeration Date:
07/13/2012