Grand Victorian of Sycamore, LLC
NPI #1154527810 in Sycamore, Illinois
Provider Information
- NPI Number
- 1154527810
- Entity Type
- Organization
- Organization Name
- Grand Victorian of Sycamore, LLC
- Primary Specialty
- Point of Service
- Enumeration Date
- Jun 21, 2007
- Last Updated
- May 13, 2008
Practice Location
Authorized Official
- Name
- MR. JOHN HOLTZ
- Title
- CONTROLLER
- Phone
- (541) 747-3373
Specialties & Taxonomy Codes
| Specialty |
|---|
| Point of Service |
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