F.a. Wrestler M.d., Ltd

NPI 1740497833 - Health Maintenance Organization - 302R00000X

NPI Details
NPI 1740497833
Enumeration Date 05/17/2007
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name FRANK ALLEN FRANK
Position OWNER
Phone (217) 355-8880
Fax (217) 355-8883
Practice Location
501 S 6TH ST
CHAMPAIGN IL, 61820-5565, US
Phone (217) 355-8880
Fax (217) 355-8883
Business Location
501 S 6TH ST
CHAMPAIGN IL, 61820-5565, US
Phone (217) 355-8880
Fax (217) 355-8883
Toxanomy
Taxonomy Code 302R00000X
License State Illinois
License Number =========
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According to our database, F.a. Wrestler M.d., Ltd NPI is 1740497833, taxonomy code is 302R00000X and license number is =========, license state is located at Illinois. F.a. Wrestler M.d., Ltd physically located at 501 S 6th St, Champaign IL, 61820-5565. NPI Number 1033115704 has the healthcare provider type.

1740497833 NPI number is provided on an as is basis without warranty of any kind. 1740497833 is maintained by the National Plan & Provider Enumeration System. The contents of F.a. Wrestler M.d., Ltd are for informational purposes only.