Full Name | |
---|---|
Speciality | Clinic/center |
Location | 3130 May Rd, Peru, Illinois |
Authorized Official Name and Position | Colleen A Adams (BILLING MANAGER) |
Authorized Official Contact | 6156618929 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 51525 Knoxville TN 37950-1525 Ph: (615) 661-8929 | 3130 May Rd Peru IL 61354-9618 Ph: (815) 224-7971 |
NPI Number | 1891976296 |
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Provider Enumeration Date | 11/14/2007 |
Last Update Date | 11/14/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891976296 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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