NPI | 1114304045 |
---|---|
Doing Business As | GIBSON AREA FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | MIKE MEUNIER Chief Compliance Officer 217-784-2286 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 0000836) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2015-10-08 |