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3908 Maryville Rd Ste 2 Granite City IL 62040-4197 | |
(618) 709-4125 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 3908 Maryville Rd Ste 2, Granite City, Illinois |
Authorized Official Name and Position | Steven Oravec (VP/COO) |
Authorized Official Contact | 6186510444 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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15 Apex Dr Highland IL 62249-1282 Ph: () - | 3908 Maryville Rd Ste 2 Granite City IL 62040-4197 Ph: (618) 709-4125 |
NPI Number | 1083190219 |
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Provider Enumeration Date | 07/11/2018 |
Last Update Date | 07/11/2018 |
Identifier | Type | State | Issuer |
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1083190219 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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