Brookstone of Emerald Glen of Olney, LLC

NPI #1326299587 in Olney, Illinois

Provider Information

NPI Number
1326299587
Entity Type
Organization
Organization Name
Brookstone of Emerald Glen of Olney, LLC
Primary Specialty
Point of Service
Enumeration Date
Oct 7, 2008
Last Updated
Oct 7, 2008

Practice Location

Address
1301 N EAST ST
City
Olney
ZIP Code
62450-2430
Phone
(618) 395-4663

Authorized Official

Name
MR. JOHN HOLTZ
Title
CONTROLLER
Phone
(541) 747-3373

Specialties & Taxonomy Codes

Specialty
Point of Service

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