Richard Fassola, PA-C

NPI #1720331671 in Eureka, Illinois

Provider Information

NPI Number: 1720331671
Entity Type: Individual
Name: Richard Fassola, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 16, 2012
Last Updated: Jun 15, 2016

Practice Location

Address: 1932 S MAIN ST
City: Eureka
State: Illinois
ZIP Code: 61530-1666
Phone: (309) 467-5000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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