John A.chanasue, M.d.ltd

NPI #1700065398 in Alton, Illinois

Provider Information

NPI Number
1700065398
Entity Type
Organization
Organization Name
John A.chanasue, M.d.ltd
Primary Specialty
Clinic/Center - Medical Specialty
Enumeration Date
Oct 31, 2007
Last Updated
Oct 31, 2007

Practice Location

Address
307 HENRY ST
Address 2
STE 200
City
Alton
ZIP Code
62002-6326
Phone
(618) 462-9623

Authorized Official

Name
DR. JOHN A CHANASUE, M.D.
Title
PRESIDENT
Phone
(618) 462-9623

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Medical SpecialtyMedical Specialty

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