BACKROAD HEALTH CARE INC

CENTRALIA, IL
NPI1134582018
Entity TypeOrganization
Authorized ContactPAUL S HAVRILKA
Fnp/Owner
618-419-0011
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
Enumeration Date2016-03-30
Last Update Date2019-03-18
Business Address
BACKROAD HEALTH CARE INC
211 S PERRINE AVE
CENTRALIA, IL 62801-3635
Phone number: 618-419-0011
Mailing Address
BACKROAD HEALTH CARE INC
314 S POPLAR ST UNIT 864
CENTRALIA, IL 62801-0848
Phone number: 618-419-0011
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