Roadside Medical, LLC
NPI #1457665382 in East Saint Louis, Illinois
Provider Information
- NPI Number
- 1457665382
- Entity Type
- Organization
- Organization Name
- Roadside Medical, LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Aug 3, 2010
- Last Updated
- Aug 3, 2010
Practice Location
- Address
- 699 STATE ROUTE 203
- Address 2
- SUITE 1
- City
- East Saint Louis
- State
- Illinois
- ZIP Code
- 62201-1608
- Phone
- (941) 225-2520
Authorized Official
- Name
- JONATHON WITHERSPOON
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (941) 225-2520
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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