Alan Scott Mahan

NPI 1790068211 - Private Vehicle - 347C00000X

NPI Details
NPI 1790068211
Gender Male
Enumeration Date 09/21/2011
Last Updated 09/21/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
1148 BROWN ST
ALTON IL, 62002-6701, US
Phone (618) 578-8436
Fax
Business Location
1148 BROWN ST
ALTON IL, 62002-6701, US
Phone (618) 578-8436
Fax
Toxanomy
Taxonomy Code 347C00000X
License State Illinois
License Number M500-0175-7349
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According to our database, Mr. Alan Scott Mahan NPI is 1790068211, taxonomy code is 347C00000X and license number is M500-0175-7349, license state is located at Illinois. Alan Scott Mahan physically located at 1148 Brown St, Alton IL, 62002-6701. NPI Number Alan Scott Mahan has the Individual type.

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1790068211 NPI number is provided on an as is basis without warranty of any kind. 1790068211 is maintained by the National Plan & Provider Enumeration System. The contents of Alan Scott Mahan are for informational purposes only.