Jefferson Street Clinic, Sc

NPI #1366637258 in Morton, Illinois

Provider Information

NPI Number
1366637258
Entity Type
Organization
Organization Name
Jefferson Street Clinic, Sc
Primary Specialty
Clinic/Center
Enumeration Date
Sep 13, 2007
Last Updated
Sep 13, 2007

Practice Location

Address
107 E JEFFERSON STREET
City
Morton
ZIP Code
61550-0180
Phone
(309) 266-9711

Authorized Official

Name
DR. LARRY STEPHEN PATTON, D.O.
Title
PRESIDENT
Phone
(309) 266-9711

Specialties & Taxonomy Codes

Specialty
Clinic/Center

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