DR. Herman Justis Dick JR., M.D.

NPI #1891891370 in Bloomington, Illinois

Provider Information

NPI Number: 1891891370
Entity Type: Individual
Name: DR. Herman Justis Dick JR., M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: M.D.
Enumeration Date: Sep 15, 2006
Last Updated: May 21, 2008

Practice Location

Address: 2204 EASTLAND DR
City: Bloomington
State: Illinois
ZIP Code: 61704-3566
Phone: (309) 662-9461

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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