PROVENA SERVICE CORPORATION

DANVILLE, IL
NPI1134314602
Entity TypeOrganization
Authorized ContactDANIEL BOLAND
Financial Reporting Specialist
815-806-3111
Organization Subpart ?Yes
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2007-09-07
Last Update Date2008-04-20
Business Address
PROVENA SERVICE CORPORATION
405 SHERIDAN ST
DANVILLE, IL 61832-4451
Phone number: 217-431-6330
Mailing Address
PROVENA SERVICE CORPORATION
9223 W SAINT FRANCIS RD
FRANKFORT, IL 60423-8330
Phone number: 815-806-3111
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