| NPI | 1063952240 |
|---|---|
| Doing Business As | SBL RANCHERO CLINIC |
| Entity Type | Organization |
| Authorized Contact | DENNIS PLUARD VP Of Operations 217-258-2102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-07 |