NPI | 1013402825 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY SCOTT TOMLIN Practice Owner 815-861-5543 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.092485) |
Enumeration Date | 2018-06-25 |
Last Update Date | 2018-08-28 |