ERA LOUISE MATTINGLY

MARION, IL
NPI1033670062
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209019019)
Enumeration Date2019-03-31
Last Update Date2019-03-31
Business Address
ERA LOUISE MATTINGLY APN
11522 WHITE PINE AVE
MARION, IL 62959-8379
Phone number: 618-889-4834
Mailing Address
ERA LOUISE MATTINGLY APN
11522 WHITE PINE AVE
MARION, IL 62959-8379
Phone number: 618-889-4834
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