| Cra | |
|
902 W Main St West Frankfort IL 62896-2210 | |
| (618) 937-6483 | |
| (618) 937-1440 |
| Full Name | Cra |
|---|---|
| Speciality | Counselor |
| Location | 902 W Main St, West Frankfort, Illinois |
| Authorized Official Name and Position | Stacy Phillips (BILLING MANAGER) |
| Authorized Official Contact | 6189376483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cra 1507 W Riddleynn Marion IL 62959 Ph: (618) 937-6483 | Cra 902 W Main St West Frankfort IL 62896-2210 Ph: (618) 937-6483 |
| NPI Number | 1073829941 |
|---|---|
| Provider Enumeration Date | 08/30/2010 |
| Last Update Date | 08/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073829941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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