Vicki Tilton, LLC

NPI #1700061983 in Bloomington, Illinois

Provider Information

NPI Number: 1700061983
Entity Type: Organization
Organization Name: Vicki Tilton, LLC
Primary Specialty: Specialist
Enumeration Date: Jan 7, 2008
Last Updated: Jan 7, 2008

Practice Location

Address: 200 W MONROE ST
Address 2: STE 309
City: Bloomington
State: Illinois
ZIP Code: 61701-3997
Phone: (309) 242-4951

Authorized Official

Name: VICKI L TILTON
Title: PRESIDENT/OWNER
Phone: (309) 242-4951

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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