Leslie J Fyans JR. PHD

NPI 1063428613 - Psychologist - 103TC0700X

NPI Details
NPI 1063428613
Gender Male
Enumeration Date 08/01/2006
Last Updated 07/18/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
3001 SPRING MILL DR
SPRINGFIELD IL, 62704-6566, US
Phone (217) 793-8900
Fax (217) 793-8389
Business Location
319 E MADISON ST
SUITE 1C
SPRINGFIELD IL, 62701-1035, US
Phone (217) 588-3699
Fax (217) 528-8743
Toxanomy
Taxonomy Code 103TC0700X
License State Illinois
License Number 071-002360
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According to our database, Dr. Leslie J Fyans JR. PHD NPI is 1063428613, taxonomy code is 103TC0700X and license number is 071-002360, license state is located at Illinois. Leslie J Fyans JR. PHD physically located at 3001 Spring Mill Dr, Springfield IL, 62704-6566. NPI Number Leslie J Fyans JR. PHD has the Individual type.

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1063428613 NPI number is provided on an as is basis without warranty of any kind. 1063428613 is maintained by the National Plan & Provider Enumeration System. The contents of Leslie J Fyans JR. PHD are for informational purposes only.