| Organization Name: | UPPER CERVICAL CARE OF ALTON LLC |
| NPI Number: | 1073880423 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WYNNDEL BUENGER (MANAGER) |
| Mailing Address: | 3 Professional Dr Suite B Alton |
| State: | IL US |
| Postal Code: | 620025067 |
| Phone Number: | 6184657177 |
| Fax Number: | |
| NPI Enumeration Date: | 11/29/2011 |
| NPI Last Update Date: | 11/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 038008971 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |