RYAN LEE BASDEN

AURORA, IL
NPI1043715899
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2083S0010X Preventive Medicine Sports Medicine
(Licence: IL  2083S0010X)
Enumeration Date2018-03-26
Last Update Date2018-03-26
Business Address
RYAN LEE BASDEN
347 S GLADSTONE AVE
AURORA, IL 60506-4877
Phone number: 618-973-0615
Mailing Address
RYAN LEE BASDEN
413 E HARRISON ST
MORTON, IL 61550-1608
Phone number:
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