Irvington Township Rural Health Clinic, Llc

NPI 1295940062 - Family Medicine - 207Q00000X

NPI Details
NPI 1295940062
Enumeration Date 05/14/2007
Last Updated 02/06/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JERRY L JERRY
Position PRESIDENT
Phone (618) 249-6203
Fax (618) 249-6263
Practice Location
205 HURON AVE
IRVINGTON IL, 62848, US
Phone (618) 249-6203
Fax (618) 249-6263
Business Location
8 ORCHARD DR
CENTRALIA IL, 62801-4937, US
Phone (618) 532-4768
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Illinois
License Number NONE
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According to our database, Irvington Township Rural Health Clinic, Llc NPI is 1295940062, taxonomy code is 207Q00000X and license number is NONE, license state is located at Illinois. Irvington Township Rural Health Clinic, Llc physically located at 205 Huron Ave, Irvington IL, 62848. NPI Number 1033115704 has the healthcare provider type.

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1295940062 NPI number is provided on an as is basis without warranty of any kind. 1295940062 is maintained by the National Plan & Provider Enumeration System. The contents of Irvington Township Rural Health Clinic, Llc are for informational purposes only.