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NPI #1053708057 in Belleville, Illinois

Provider Information

NPI Number
1053708057
Entity Type
Organization
Organization Name
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Primary Specialty
Nursing Care
Enumeration Date
Apr 17, 2015
Last Updated
Apr 17, 2015

Practice Location

Address
3001 SAVE RD
ZIP Code
62221-7018
Phone
(618) 234-1992

Authorized Official

Name
RANDY LAW
Title
EXECUTIVE ADMINISTRATOR
Phone
(618) 234-1992

Specialties & Taxonomy Codes

Specialty
Nursing Care

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