Charleston Primary Care Inc.
NPI #1770905952 in Charleston, Illinois
Provider Information
- NPI Number
- 1770905952
- Entity Type
- Organization
- Organization Name
- Charleston Primary Care Inc.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jan 7, 2014
- Last Updated
- Jan 7, 2014
Practice Location
- Address
- 506 W LINCOLN AVE
- Address 2
- SUITE 200
- City
- Charleston
- State
- Illinois
- ZIP Code
- 61920-2453
- Phone
- (217) 348-8730
Authorized Official
- Name
- DANELLE JACKSON, MSN, APN, NP-C
- Title
- OWNER
- Phone
- (217) 276-6421
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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