Eastland Medical Plaza Surgicenter, LLC

NPI #1699751289 in Bloomington, Illinois

Provider Information

NPI Number
1699751289
Entity Type
Organization
Organization Name
Eastland Medical Plaza Surgicenter, LLC
Primary Specialty
Clinic/Center - Ambulatory Surgical
Enumeration Date
Dec 16, 2005
Last Updated
Jan 6, 2010

Practice Location

Address
1505 EASTLAND DR
ZIP Code
61701-3534
Phone
(309) 663-1997

Authorized Official

Name
MRS. JACKIE ANN FRYE
Title
BUSINESS OFFICE MANAGER
Phone
(309) 663-1997

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Ambulatory SurgicalAmbulatory Surgical

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